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1. Unimproved water and sanitation contributes to childhood diarrhoea during the war in Tigray, Ethiopia: a community based assessment

Author

Akeza Awealom Asgedom, Birhanu Tewoldemedhin Abirha, Askual Girmay Tesfay, Kelali Kaleaye Gebreyowhannes, Hayelom Birhanu Abraha, Gessessew Bugssa Hailu, Mesele Bahre Abrha, Mache Tsadik, Tesfay Gebregziabher Gebrehiwet, Aregawi Gebreyesus, Tilahun Desalew, Yibrah Alemayehu, and Afework Mulugeta

Subjects
Medicine, Science
Abstract

Abstract Access to water, sanitation, and hygiene (WASH) is a global public health problem. The situation is worst in conflict areas, where people are displaced from their usual homes. Household supply of WASH and the incidence of diarrhoeal disease among children during the war in Tigray are not known or documented. The objective of this study was to investigate the sources of drinking water, sanitation and hygiene practices, and the incidence of diarrhoeal diseases among children during the war in Tigray, Ethiopia. A cross—sectional study was conducted to collect data on selected WASH indicators in six zones of Tigray from August 4-20, 2021. Data were collected from a total of 4381 sample households selected by lottery. Descriptive analysis was performed and the analysed data are presented in tables, figures and explanatory notes. Binary logistic regression was performed to examine the relationship between independent and dependent variables. A total of 4381 households from 52 woredas participated in the study. Approximately 67.7% of the study participants reported that they relied on an improved source of drinking water during the war. Coverage of sanitation, hand washing, and menstrual hygiene during the war was reported as 43.9%, 14.5%, and 22.1%, respectively. The prevalence of diarrhoeal diseases among children was 25.5% during the war. Water source, latrine type, solid waste disposal and health extension worker visits were the significant predictors of the likelihood of diarrhoea in children (p

Published
2023
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2. Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000–17

Author

Kirsten E Wiens, Paulina A Lindstedt, Brigette F Blacker, Kimberly B Johnson, Mathew M Baumann, Lauren E Schaeffer, Hedayat Abbastabar, Sr, Foad Abd-Allah, Ahmed Abdelalim, Ibrahim Abdollahpour, Kedir Hussein Abegaz, Ayenew Negesse Abejie, Lucas Guimarães Abreu, Michael R M Abrigo, Ahmed Abualhasan, Manfred Mario Kokou Accrombessi, Dilaram Acharya, Maryam Adabi, Abdu A Adamu, Oladimeji M Adebayo, Rufus Adesoji Adedoyin, Sr, Victor Adekanmbi, Olatunji O Adetokunboh, Sr, Beyene Meressa Adhena, Mohsen Afarideh, Sohail Ahmad, Keivan Ahmadi, Anwar E Ahmed, Muktar Beshir Ahmed, Rushdia Ahmed, Temesgen Yihunie Akalu, Fares Alahdab, Ziyad Al-Aly, Noore Alam, Sr, Samiah Alam, Genet Melak Alamene, Turki M Alanzi, Jacqueline Elizabeth Alcalde-Rabanal, Beriwan Abdulqadir Ali, Mehran Alijanzadeh, Vahid Alipour, Syed Mohamed Aljunid, Ali Almasi, Sr, Amir Almasi-Hashiani, Hesham M Al-Mekhlafi, Khalid A Altirkawi, Nelson Alvis-Guzman, Nelson J Alvis-Zakzuk, Saeed Amini, Sr, Arianna Maever L Amit, Sr, Catalina Liliana Andrei, Sr, Mina Anjomshoa, Amir Anoushiravani, Sr, Fereshteh Ansari, Carl Abelardo T Antonio, Benny Antony, Ernoiz Antriyandarti, Jalal Arabloo, Hany Mohamed Amin Aref, Sr, Olatunde Aremu, Bahram Armoon, Amit Arora, Sr, Krishna K Aryal, Afsaneh Arzani, Mehran Asadi-Aliabadi, Hagos Tasew Atalay, Seyyed Shamsadin Athari, Sr, Seyyede Masoume Athari, Sachin R Atre, Marcel Ausloos, Nefsu Awoke, Beatriz Paulina Ayala Quintanilla, Getinet Ayano, Martin Amogre Ayanore, Sr, Yared Asmare Aynalem IV, Samad Azari, Peter S Azzopardi, Ebrahim Babaee, Tesleem Kayode Babalola, Alaa Badawi, Sr, Mohan Bairwa, Shankar M Bakkannavar, Senthilkumar Balakrishnan, Ayele Geleto Bali, Maciej Banach, Sr, Joseph Adel Mattar Banoub, Sr, Aleksandra Barac, Till Winfried Bärnighausen, Huda Basaleem, Sanjay Basu, Vo Dinh Bay, Mohsen Bayati, Estifanos Baye, Neeraj Bedi, Mahya Mahya Beheshti Beheshti, Masoud Behzadifar, Meysam Behzadifar, Bayu Begashaw Bekele, Yaschilal Muche Belayneh, Michellr L Bell, Sr, Derrick A Bennett, Sr, Dessalegn Ajema Berbada, Robert S Bernstein, Anusha Ganapati Bhat, Sr, Krittika Bhattacharyya, Sr, Suraj Bhattarai, Soumyadeep Bhaumik, Zulfiqar A Bhutta, Ali Bijani, Boris Bikbov, Binyam Minuye Birihane IV, Raaj Kishore Biswas, Somayeh Bohlouli, Hunduma Amensisa Amensisa Bojia I, Soufiane Boufous, Oliver J Brady, Nicola Luigi Bragazzi, Andrey Nikolaevich Briko, Nikolay Ivanovich Briko, Gabrielle B Britton, Sharath Burugina Nagaraja, Sr, Reinhard Busse, Sr, Zahid A Butt, Luis LA Alberto Cámera, Sr, Ismael R Campos-Nonato, Sr, Jorge Cano, Josip Car, Rosario Cárdenas, Felix Carvalho, Sr, Carlos A Castañeda-Orjuela, Sr, Franz Castro, Wagaye Fentahun Chanie, Sr, Pranab Chatterjee, Vijay Kumar Chattu, Tesfaye Yitna Yitna Chichiabellu, Jr, Ken Lee Chin, Sr, Devasahayam J Christopher, Dinh-Toi Chu, Natalie Maria Cormier, Vera Marisa Costa, Carlos Culquichicon, Matiwos Soboka Daba, Giovanni Damiani, Sr, Lalit Dandona, Rakhi Dandona, Anh Kim Dang, Aso Mohammad Darwesh, Amira Hamed Darwish, Ahmad Daryani, Sr, Jai K Das, Rajat Das Gupta, Aditya Prasad Dash, Gail Davey, Claudio Alberto Dávila-Cervantes, Adrian C Davis, Sr, Dragos Virgil Davitoiu, Fernando Pio De la Hoz, Asmamaw Bizuneh Demis, Dereje Bayissa Demissie, Getu Debalkie Demissie, Gebre Teklemariam Demoz, Sr, Edgar Denova-Gutiérrez, Sr, Kebede Deribe, Sr, Assefa Desalew, Aniruddha Deshpande, Samath Dhamminda Dharmaratne, Preeti Dhillon, Meghnath Dhimal, Govinda Prasad Dhungana, Daniel Diaz, Sr, Isaac Oluwafemi Dipeolu, Shirin Djalalinia, Kerrie E Doyle, Eleonora Dubljanin, Bereket Duko, Andre Rodrigues Duraes, Mohammad Ebrahimi Kalan, Hisham Atan Edinur, Sr, Andem Effiong, Sr, Aziz Eftekhari, Nevine El Nahas, Iman El Sayed, Maysaa El Sayed Zaki, Maha El Tantawi, Teshome Bekele Elema I, Hala Rashad Elhabashy, Sr, Shaimaa I El-Jaafary, Hajer Elkout, Aisha Elsharkawy, Iqbal RF Elyazar, Aklilu Endalamaw, Daniel Adane Endalew, Sr, Sharareh Eskandarieh, Alireza Esteghamati, Sadaf Esteghamati, Sr, Arash Etemadi, Oluchi Ezekannagha, Mohammad Fareed, Roghiyeh Faridnia, Farshad Farzadfar, Mehdi Fazlzadeh, Valery L Feigin, Sr, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Irina Filip, Florian Fischer, Nataliya A Foigt, Morenike Oluwatoyin Folayan, Sr, Masoud Foroutan, Richard Charles Franklin, Takeshi Fukumoto, Mohamed M Gad, Reta Tsegaye Gayesa, Teshome Gebre, Sr, Ketema Bizuwork Gebremedhin, Gebreamlak Gebremedhn Gebremeskel, Sr, Hailay Abrha Gesesew, Kebede Embaye Gezae, Keyghobad Ghadiri, Sr, Ahmad Ghashghaee, Pramesh Raj Ghimire, Sr, Paramjit Singh Gill, Sr, Tiffany K Gill, Themba G G Ginindza, Nelson G M Gomes, Sameer Vali Gopalani, Alessandra C Goulart, Bárbara Niegia Garcia Goulart, Ayman Grada, Mohammed Ibrahim Mohialdeen Gubari, Harish Chander Gugnani, Sr, Davide Guido, Rafael Alves Guimarães, Yuming Guo, Sr, Rajeev Gupta, Nima Hafezi-Nejad, Dessalegn H Haile, Sr, Gessessew Bugssa Hailu, Arvin Haj-Mirzaian, Arya Haj-Mirzaian, Randah R Hamadeh, Samer Hamidi, Demelash Woldeyohannes Handiso, Hamidreza Haririan, Sr, Ninuk Hariyani, Ahmed I Hasaballah, Md Mehedi Hasan, Edris Hasanpoor, Amir Hasanzadeh, Hadi Hassankhani, Hamid Yimam Hassen, Mohamed I Hegazy, Behzad Heibati, Behnam Heidari, Delia Hendrie, Sr, Nathaniel J Henry, Claudiu Herteliu, Fatemeh Heydarpour, Hagos Degefa de Hidru I, Thomas R Hird, Chi Linh Hoang, Enayatollah Homaie Rad, Praveen Hoogar, Mohammad Hoseini, Naznin Hossain, Mostafa Hosseini, Mehdi Hosseinzadeh, Mowafa Househ, Mohamed Hsairi, Sr, Guoqing Hu, Mohammedaman Mama Hussen, Segun Emmanuel Ibitoye, Ehimario U Igumbor, Sr, Olayinka Stephen Ilesanmi, Milena D Ilic, Mohammad Hasan Imani-Nasab, Usman Iqbal, Seyed Sina Naghibi Irvani, Sheikh Mohammed Shariful Islam, Chinwe Juliana Iwu, Neda Izadi, Sr, Anelisa Jaca, Nader Jahanmehr, Mihajlo Jakovljevic, Amir Jalali, Achala Upendra Jayatilleke, Ravi Prakash Jha, Vivekanand Jha, John S Ji, Sr, Jost B Jonas, Jacek Jerzy Jozwiak, Ali Kabir, Zubair Kabir, Sr, Amaha Kahsay, Hamed Kalani, Tanuj Kanchan, Behzad Karami Matin, André Karch, Mohd Anisul Karim, Hamidreza Karimi-Sari, Surendra Karki, Amir Kasaeian, Gebremicheal Gebreslassie Kasahun, Yawukal chane Kasahun, Habtamu Kebebe Kasaye, Gebrehiwot G Kassa, Getachew Mullu Kassa, Gbenga A Kayode, Ali Kazemi Karyani, Mihiretu M Kebede, Peter Njenga Keiyoro, Abraham Getachew Kelbore, Sr, Andre Pascal Kengne, Sr, Daniel Bekele Ketema, Yousef Saleh Khader, Morteza Abdullatif Khafaie, Nauman Khalid, Rovshan Khalilov, Ejaz Ahmad Khan, Sr, Junaid Khan, Md Nuruzzaman Khan I, Muhammad Shahzeb Khan, Khaled Khatab, Sr, Amir M Khater, Mona M Khater, Maryam Khayamzadeh, Mohammad Khazaei, Salman Khazaei, Mohammad Hossein Khosravi, Jagdish Khubchandani, Ali Kiadaliri, Yun Jin Kim, Ruth W Kimokoti, Adnan Kisa, Sezer Kisa, Niranjan Kissoon, Sr, Shivakumar KM Marulasiddaiah M KMShivakumar, Sr, Sonali Kochhar, Tufa Kolola, Sr, Hamidreza Komaki, Soewarta Kosen, Parvaiz A Koul, Ai Koyanagi, Moritz U G Kraemer, Kewal Krishan, Nuworza Kugbey, G Anil Kumar, Manasi Kumar, Sr, Pushpendra Kumar, Vivek Kumar, Dian Kusuma, Carlo La Vecchia, Ben Lacey, Sheetal D Lad, Dharmesh Kumar Lal, Felix Lam, Faris Hasan Lami, Sr, Prabhat Lamichhane, Van Charles Lansingh, Savita Lasrado, Avula Laxmaiah, Paul H Lee, Sr, Kate E LeGrand, Mostafa Leili, Tsegaye Lolaso Lenjebo, Cheru Tesema Leshargie, Sr, Aubrey J Levine, Shanshan Li, Sr, Shai Linn, Shiwei Liu, Simin Liu, Rakesh Lodha, Joshua Longbottom, Jaifred Christian F Lopez, Hassan Magdy Abd El Razek, Muhammed Magdy Abd El Razek, D R Mahadeshwara Prasad, Phetole Walter Mahasha, Sr, Narayan B Mahotra, Azeem Majeed, Reza Malekzadeh, Sr, Deborah Carvalho Malta, Abdullah A Mamun, Sr, Navid Manafi, Sr, Ana Laura Manda, Narendar Dawani Dawanu Manohar, Mohammad Ali Mansournia, Chabila Christopher Mapoma, Joemer C Maravilla, Gabriel Martinez, Sr, Santi Martini, Francisco Rogerlândio Martins-Melo, Anthony Masaka, Benjamin Ballard Massenburg, Manu Raj Mathur, Benjamin K Mayala, Mohsen Mazidi, Colm McAlinden, Birhanu Geta Meharie, Man Mohan Mehndiratta, Sr, Kala M Mehta, Tefera C Chane Mekonnen, Gebrekiros Gebremichael Meles, Peter T N Memiah, Ziad A Memish, Sr, Walter Mendoza, Ritesh G Menezes, Seid Tiku Mereta, Tuomo J Meretoja, Sr, Tomislav Mestrovic, Bartosz Miazgowski, Kebadnew Mulatu Mihretie, Sr, Ted R Miller, GK Mini, Erkin M Mirrakhimov, Babak Moazen, Bahram Mohajer, Amjad Mohamadi-Bolbanabad, Dara K Mohammad, Karzan Abdulmuhsin Mohammad, Yousef Mohammad, Naser Mohammad Gholi Mezerji, Roghayeh Mohammadibakhsh, Noushin Mohammadifard, Jemal Abdu Mohammed, Sr, Shafiu Mohammed, Farnam Mohebi, Ali H Mokdad, Mariam Molokhia, Lorenzo Monasta, Yoshan Moodley, Sr, Catrin E Moore, Sr, Ghobad Moradi, Masoud Moradi, Mohammad Moradi-Joo, Maziar Moradi-Lakeh, Paula Moraga, Linda Morales, Ilais Moreno Velásquez, Abbas Mosapour, Simin Mouodi, Seyyed Meysam Mousavi, Miliva Mozaffor I, Kindie Fentahun Muchie, Sr, Getahun Fentaw Mulaw, Sr, Sandra B Munro, Moses K Muriithi, Christopher J L Murray, GVS Murthy, Kamarul Imran Musa, Ghulam Mustafa, Sr, Saravanan Muthupandian, Sr, Ashraf F Nabhan, Mehdi Naderi, Ahamarshan Jayaraman Nagarajan, Kovin S Naidoo, Gurudatta Naik, Farid Najafi, Vinay Nangia, Sr, Jobert Richie Nansseu, Bruno Ramos Nascimento, Sr, Javad Nazari, Duduzile Edith Ndwandwe, Sr, Ionut Negoi, Sr, Henok Biresaw Netsere Netsere, Sr, Josephine W Ngunjiri, Sr, Cuong Tat Nguyen, Huong Lan Thi Nguyen, Trang Huyen Nguyen, Dabere Nigatu, Solomon Gedlu Nigatu, Dina Nur Anggraini Ningrum, Chukwudi A Nnaji, Marzieh Nojomi, Vuong Minh Nong, Ole F Norheim, Sr, Jean Jacques Noubiap, Soraya Nouraei Motlagh, Bogdan Oancea, Okechukwu Samuel Ogah, Felix Akpojene Ogbo, In-Hwan Oh, Andrew T Olagunju, Tinuke O Olagunju, Bolajoko Olubukunola Olusanya, Jacob Olusegun Olusanya, Obinna E Onwujekwe, Sr, Eyal Oren, Doris V V Ortega-Altamirano, Sr, Osayomwanbo Osarenotor, Frank B Osei, Sr, Mayowa O Owolabi, Mahesh P A, Sr, Jagadish Rao Padubidri, Smita Pakhale, Sangram Kishor Patel, Angel J Paternina-Caicedo, Sr, Ashish Pathak, Sr, George C Patton, Deepak Paudel, Sr, Kebreab Paulos, Sr, Veincent Christian Filipino Pepito, Alexandre Pereira, Norberto Perico, Aslam Pervaiz, Julia Moreira Pescarini, Bakhtiar Piroozi, Meghdad Pirsaheb, Maarten J Postma, Hadi Pourjafar, Farshad Pourmalek, Sr, Akram Pourshams, Hossein Poustchi, Sergio I Prada, Sr, Narayan Prasad, Liliana Preotescu, Hedley Quintana, Navid Rabiee, Amir Radfar, Alireza Rafiei, Fakher Rahim, Afarin Rahimi-Movaghar, Vafa Rahimi-Movaghar, Mohammad Hifz Ur Rahman, Muhammad Aziz Rahman, SHAFIUR Rahman, Fatemeh Rajati, Sr, Saleem Muhammad Rana, Sr, Chhabi Lal Ranabhat, Davide Rasella, David Laith Rawaf, Salman Rawaf, Sr, Lal Rawal, Wasiq Faraz Rawasia, Vishnu Renjith, Andre M N Renzaho, Sr, Serge Resnikoff, Sr, Melese Abate Reta, Negar Rezaei, Mohammad sadegh Rezai, Seyed Mohammad Riahi, Ana Isabel Ribeiro, Jennifer Rickard, Sr, Maria Rios-Blancas, Leonardo Roever, Luca Ronfani, Elias Merdassa Roro, Sr, Jennifer M Ross, Enrico Rubagotti, Salvatore Rubino, Anas M Saad, Yogesh Damodar Sabde, Siamak Sabour, Ehsan Sadeghi, Sr, Yahya Safari, Roya Safari-Faramani, Rajesh Sagar, Amirhossein Sahebkar, Mohammad Ali Sahraian, S Mohammad Sajadi, Mohammad Reza Salahshoor, Nasir Salam, Sr, Payman Salamati, Hosni Salem, Marwa R Rashad Salem I, Yahya Salimi, Hamideh Salimzadeh, Abdallah M Samy, Juan Sanabria, Sr, Milena M Santric-Milicevic, Bruno Piassi Sao Jose, Sivan Yegnanarayana Iyer Saraswathy, Kaushik Sarkar, Sr, Abdur Razzaque Sarker, Nizal Sarrafzadegan I, Benn Sartorius, Brijesh Sathian, Thirunavukkarasu Sathish, Monika Sawhney, Sonia Saxena, Sr, David C Schwebel, Sr, Anbissa Muleta Senbeta IV, Subramanian Senthilkumaran, Sadaf G Sepanlou, Edson Serván-Mori, Sr, Hosein Shabaninejad, Azadeh Shafieesabet, Sr, Masood Ali Shaikh, Ali S Shalash, Sr, Seifadin Ahmed Shallo, Mehran Shams-Beyranvand, MohammadBagher Shamsi, Morteza Shamsizadeh, Mohammed Shannawaz, Kiomars Sharafi, Hamid Sharifi, Hatem Samir Shehata, Sr, Aziz Sheikh, B Suresh Kumar Shetty, Sr, Kenji Shibuya, Sr, Wondimeneh Shibabaw Shiferaw, Sr, Desalegn Markos Shifti, Mika Shigematsu, Jae Il Shin, Rahman Shiri, Sr, Reza Shirkoohi, Soraya Siabani, Tariq Jamal Siddiqi, Diego Augusto Santos Silva, Ambrish Singh, Jasvinder A Singh, Narinder Pal Singh, Virendra Singh, Malede Mequanent Sisay, Eirini Skiadaresi, Mohammad Reza Sobhiyeh, Sr, Anton Sokhan, Shahin Soltani, Ranjani Somayaji, Moslem Soofi, Muluken Bekele Sorrie, Sr, Ireneous N Soyiri, Chandrashekhar T Sreeramareddy, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Sr, Hafiz Ansar Rasul Suleria, Marufa Sultana, Bruno Fokas Sunguya, Bryan L Sykes, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Degena Bahrey Tadesse, Jr, Ingan Ukur Tarigan, Aberash Abay Tasew, Yonatal Mesfin Tefera, Sr, Merhawi Gebremedhin Tekle, Mohamad-Hani Temsah, Berhe Etsay Tesfay I, Fisaha Haile Haile Tesfay, Belay Tessema, Zemenu Tadesse Tessema, Kavumpurathu Raman Thankappan, Nihal Thomas, Alemayehu Toma Toma, Sr, Roman Topor-Madry, Marcos Roberto Roberto Tovani-Palone, Eugenio Traini, Bach Xuan Tran, Khanh Bao Tran, Irfan Ullah, Bhaskaran Unnikrishnan, Muhammad Shariq Usman, Sr, Benjamin S Chudi Uzochukwu, Sr, Pascual R Valdez, Santosh Varughese, Sr, Francesco S Violante, Sr, Sebastian Vollmer, Sr, Feleke Gebremeskel W/hawariat, Sr, Yasir Waheed, Mitchell Taylor Wallin, Yafeng Wang, Yuan-Pang Wang, Marcia Weaver, Bedilu Girma Weji, Girmay Teklay Weldesamuel, Catherine A Welgan, Andrea Werdecker, Ronny Westerman, Sr, Taweewat Wiangkham, Charles Shey Wiysonge, Sr, Haileab Fekadu Wolde, Sr, Dawit Zewdu Wondafrash, Tewodros Eshete Wonde, Sr, Getasew Taddesse Worku, Sr, Ai-Min Wu, Gelin Xu, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Tomohide Yamada, Sr, Hiroshi Yatsuya, Alex Yeshaneh, Christopher Sabo Yilgwan, Mekdes Tigistu Yilma, Paul Yip, Sr, Engida Yisma, Naohiro Yonemoto, Sr, Seok-Jun Yoon, Mustafa Z Younis, Mahmoud Yousefifard, Hebat-Allah Salah A Yousof, Chuanhua Yu, Hasan Yusefzadeh, Siddhesh Zadey, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Hamed Zandian, Nejimu Biza Zepro, Taddese Alemu Zerfu, Yunquan Zhang, Xiu-Ju George Zhao, Arash Ziapour, Sanjay Zodpey, Sr, Yves Miel H Zuniga, Simon I Hay, and Robert C Reiner, Jr

Subjects
Public aspects of medicine, RA1-1270
Abstract

Summary: Background: Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs. Methods: We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received ORS or RHF (or both) on continuous continent-wide surfaces in 2000–17, and aggregated results to policy-relevant administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and creating uncertainty intervals (UIs) with the 2·5th and 97·5th percentiles of those 250 draws. Findings: While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage remained below 50% in the majority (62·6%; 12 417 of 19 823) of second administrative-level units and an estimated 6 519 000 children (95% UI 5 254 000–7 733 000) with diarrhoea were not treated with any form of ORT in 2017. Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall ORT coverage from 2000 to 2017. Although ORS was uniformly distributed subnationally in some countries, within-country geographical inequalities persisted in others; 11 countries had at least a 50% difference in one of their units compared with the country mean. Increases in ORS use over time were correlated with declines in RHF use and in diarrhoeal mortality in many locations, and an estimated 52 230 diarrhoeal deaths (36 910–68 860) were averted by scaling up of ORS coverage between 2000 and 2017. Finally, we identified key subnational areas in Colombia, Nigeria, and Sudan as examples of where diarrhoeal mortality remains higher than average, while ORS coverage remains lower than average. Interpretation: To our knowledge, this study is the first to produce and map subnational estimates of ORS, RHF, and ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, allowing for tracking progress over time. Our novel results, combined with detailed subnational estimates of diarrhoeal morbidity and mortality, can support subnational needs assessments aimed at furthering policy makers' understanding of within-country disparities. Over 50 years after the discovery that led to this simple, cheap, and life-saving therapy, large gains in reducing mortality could still be made by reducing geographical inequalities in ORS coverage. Funding: Bill & Melinda Gates Foundation.

Published
2020
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3. Injury-related gaining momentum as external causes of deaths in Ethiopian health and demographic surveillance sites: evidence from verbal autopsy study

Author

Kassahun Alemu Gelaye, Fasil Tessema, Befikadu Tariku, Semaw Ferede Abera, Alemseged Aregay Gebru, Nega Assefa, Desalew Zelalem, Melkamu Dedefo, Mekdes Kondal, Mesfin Kote, Mitike Molla Sisay, Wubegzier Mekonnen, Mamo Wubshet Terefe, Gashaw Andargie Biks, Firehywot Eshetu, Mulumebet Abera, Yoseph Fekadu, Gessessew Bugssa Hailu, Etsehiwot Tilahun, and Yihunie Lakew

Subjects
Accidents, assault, drowning, external causes, mortality, suicide, transport, verbal autopsy, Ethiopia, Public aspects of medicine, RA1-1270
Abstract

Background: In Ethiopia, though all kinds of mortality due to external causes are an important component of overall mortality often not counted or documented on an individual basis. Objective: The aim of this study was to describe the patterns of mortality from external causes using verbal autopsy (VA) method at the Ethiopian HDSS Network sites. Methods: All deaths at Ethiopian HDSS sites were routinely registered and followed up with VA interviews. The VA forms comprised deaths up to 28 days, between four weeks and 14 years and 15 years and above. The cause of a death was ascertained based on an interview with next of families or other caregivers using a standardized questionnaire that draws information on signs, symptoms, medical history and circumstances preceding death after 45 days mourning period. Two physician assigned probable causes of death as underlying, immediate and contributing factors independently using information in VA forms based on the WHO ICD-10 and VA code system. Disagreed cases sent to third physician for independent review and diagnosis. The final cause of death considered when two of the three physicians assigned underlying cause of death; otherwise, labeled as undetermined. Results: In the period from 2009 to 2013, a total of 9719 deaths were registered. Of the total deaths, 623 (6.4%) were from external causes. Of these, accidental drowning and submersion, 136 (21.8%), accidental fall, 113 (18.1%) and transport-related accidents, 112 (18.0%) were the topmost three leading external causes of deaths. About 436 (70.0%) of deaths were from the age group above 15 years old. Drowning and submersion and transport-related accidents were high in age group between 5 and 14 years old. Conclusion: In this study, external causes of death are significant public health problems and require attention as one of prior health agenda.

Published
2018
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4. Quantifying risks and interventions that have affected the burden of lower respiratory infections among children younger than 5 years

Author

Tesfaye Dessale Kassa, Félix Carvalho, Luke D. Knibbs, Sonia Lewycka, Sonali Kochhar, Aaron Cohen, Luca Ronfani, Ebrahim M Yimer, Srinivas Murthy, Ejaz Ahmad Khan, Josip Car, Rodrigo Sarmiento-Suarez, Babak Moazen, Mostafa Qorbani, Javad Nazari, Nancy Fullman, Niranjan Kissoon, Keyghobad Ghadiri, Marissa B Reitsma, Benn Sartorius, Ashish Awasthi, Aman Yesuf Endries, Christopher Troeger, Evanson Z. Sambala, Nelson Alvis-Guzman, Alessandra C. Goulart, Erlyn Rachelle King Macarayan, Ahmad Daryani, Fakher Rahim, Fiseha Wadilo Wada, Yuming Guo, Sonia Saxena, Justin R. Ortiz, Monika Sawhney, Eyal Oren, Alaa Badawi, Tomislav Mestrovic, Sezer Kisa, Cheru Tesema Leshargie, Ai Koyanagi, Long Hoang Nguyen, Alireza Rafiei, Aziz Rezapour, Huong Lan Thi Nguyen, Abdallah M. Samy, Catrin E. Moore, André Karch, Seyyed Meysam Mousavi, Chi Linh Hoang, Katie R Nielsen, Eleonora Dubljanin, Giuseppe Gorini, Charles Shey Wiysonge, Bach Xuan Tran, Christopher J L Murray, Khanh Bao Tran, Maarten J. Postma, Mohammad Sadegh Rezai, Bartosz Miazgowski, Hagos Tasew Atalay, Aziz Sheikh, Reginald Quansah, Kirsten E. Wiens, Mika Shigematsu, Devasahayam J. Christopher, Hamid Yimam Hassen, Yasir Waheed, Robert Reiner, Smita Pakhale, Joseph Adel Mattar Banoub, Fares Alahdab, Vafa Rahimi-Movaghar, Mahesh P A, Ruth W Kimokoti, Feleke Mekonnen Demeke, Mohamad-Hani Temsah, Zakir Hussain, Naohiro Yonemoto, Noore Alam, Mu'awiyyah Babale Sufiyan, Lidia Morawska, Adane Teshome Kefale, Ali H. Mokdad, Rachel L Updike, Amir Kasaeian, Yousef Veisani, Rajesh Kumar Rai, Jeffrey D. Stanaway, Mina Anjomshoa, Corey B. Bills, Puja C Rao, Euripide Frinel G Arthur Avokpaho, Lorenzo Monasta, Zoubida Zaidi, Yousef Khader, Heather J. Zar, Ali Bijani, Tommi Vasankari, Kefyalew Addis Alene, Young-Ho Khang, Afewerki Gebremeskel Tsadik, Joseph Frostad, Ghulam Mustafa, Jalal Arabloo, Rajaa Al-Raddadi, Shanshan Li, David L. Smith, Maria Jesus Rios-Blancas, Carlos A Castañeda-Orjuela, Syed Mohamed Aljunid, Andrew T Olagunju, Suleman Atique, Abdullah T Khoja, Ibrahim A Khalil, William M. Gardner, Zikria Saleem, Addisu Melese, Stephen S Lim, Eyasu Ejeta Duken, Erkin M. Mirrakhimov, Gessessew Bugssa Hailu, Hmwe H Kyu, Seyedmojtaba Seyedmousavi, Aleksandra Barac, Spencer L. James, Salvatore Rubino, Lalit Dandona, Arya Haj-Mirzaian, Kate Causey, Nicholas J Kassebaum, Simon I. Hay, Ravi Prakash Jha, Karzan Abdulmuhsin Mohammad, Son Hoang Nguyen, Belay Tessema, Muhammad Imran Nisar, Barthelemy Kuate Defo, Alireza Ahmadi, Theo Vos, Krittika Bhattacharyya, Irfan Ullah, Molly H Biehl, Kalpana Balakrishnan, Tinuke O Olagunju, Florian Fischer, Olatunde Aremu, Brigette F. Blacker, Derrick A Bennett, Vahid Alipour, Carl Abelardo T. Antonio, Manisha Dubey, Tuomo J. Meretoja, G Anil Kumar, Varshil Mehta, Molly R Nixon, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Anselm Okoro, Zulfiqar A Bhutta, Maysaa El Sayed Zaki, Shafiu Mohammed, Nuruzzaman Khan, Jost B. Jonas, Samah Awad, Miloje Savic, Soewarta Kosen, Quique Bassat, Amha Admasie, Cuong Tat Nguyen, Chalachew Genet Akal, Milena M Santric Milicevic, Adnan Kisa, Arvin Haj-Mirzaian, Jonathan F. Mosser, Stephanie R M Zimsen, Dharmesh Kumar Lal, Birhanu Geta, Nobuyuki Horita, Gulfaraz Khan, Saeed Amini, Ziad A. Memish, Rakhi Dandona, Alyssa N. Sbarra, Dietrich Rothenbacher, Samer Hamidi, Felix Akpojene Ogbo, Helena Manguerra, Shirin Djalalinia, Degu Abate, Rakesh Lodha, Samuel B. Albertson, Seyed Sina Naghibi Irvani, Abdullah Al Mamun, Neeraj Bedi, Parvaiz A Koul, Desalegn Tadese Mengistu, Katie Welgan, Masood Ali Shaikh, Marek Majdan, Mihaela Hostiuc, Mohamed Lemine Cheikh brahim Ahmed, Public Health, GBD Lower Resp Infect, Microbes in Health and Disease (MHD), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Collaborators, GBD 2017 Lower Respiratory Infections, Clinicum, Institute for Molecular Medicine Finland, HUS Comprehensive Cancer Center, Staff Services, University of Helsinki, II kirurgian klinikka, and Department of Oncology

Subjects
Male, Psychological intervention, Global Health, Global Burden of Disease, 0302 clinical medicine, Risk Factors, Case fatality rate, Medicine, 030212 general & internal medicine, Respiratory Tract Infections, INFLUENZAE TYPE-B, education.field_of_study, NUTRITION TRANSITION, CHALLENGES, Trastornos respiratorios, Incidence (epidemiology), Mortality rate, Incidence, Enfermedades en niños, CHILDHOOD PNEUMONIA, Children younger than 5 years, 3. Good health, Infectious Diseases, Child, Preschool, Child Mortality, Female, TERRITORIES, CONJUGATE VACCINE, 030231 tropical medicine, Population, 195 COUNTRIES, Infections, Article, CHINA, 03 medical and health sciences, Age Distribution, Nutrition transition, SYSTEMATIC ANALYSIS, Humans, Risk factor, education, Lower respiratory, Models, Statistical, business.industry, AIR-POLLUTION, Verbal autopsy, Enfermedades respiratorias, Socioeconomic Factors, 3121 General medicine, internal medicine and other clinical medicine, Human medicine, business, Demography
Abstract

Background Despite large reductions in under-5 lower respiratory infection (LRI) mortality in many locations, the pace of progress for LRIs has generally lagged behind that of other childhood infectious diseases. To better inform programmes and policies focused on preventing and treating LRIs, we assessed the contributions and patterns of risk factor attribution, intervention coverage, and sociodemographic development in 195 countries and territories by drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) LRI estimates. Methods We used four strategies to model LRI burden: the mortality due to LRIs was modelled using vital registration data, demographic surveillance data, and verbal autopsy data in a predictive ensemble modelling tool; the incidence of LRIs was modelled using population representative surveys, health-care utilisation data, and scientific literature in a compartmental meta-regression tool; the attribution of risk factors for LRI mortality was modelled in a counterfactual framework; and trends in LRI mortality were analysed applying changes in exposure to risk factors over time. In GBD, infectious disease mortality, including that due to LRI, is among HIV-negative individuals. We categorised locations based on their burden in 1990 to make comparisons in the changing burden between 1990 and 2017 and evaluate the relative percent change in mortality rate, incidence, and risk factor exposure to explain differences in the health loss associated with LRIs among children younger than 5 years. Findings In 2017, LRIs caused 808 920 deaths (95% uncertainty interval 747 286–873 591) in children younger than 5 years. Since 1990, there has been a substantial decrease in the number of deaths (from 2 337 538 to 808 920 deaths; 65·4% decrease, 61·5–68·5) and in mortality rate (from 362·7 deaths [330·1–392·0] per 100 000 children to 118·9 deaths [109·8–128·3] per 100 000 children; 67·2% decrease, 63·5–70·1). LRI incidence declined globally (32·4% decrease, 27·2–37·5). The percent change in under-5 mortality rate and incidence has varied across locations. Among the risk factors assessed in this study, those responsible for the greatest decrease in under-5 LRI mortality between 1990 and 2017 were increased coverage of vaccination against Haemophilus influenza type b (11·4% decrease, 0·0–24·5), increased pneumococcal vaccine coverage (6·3% decrease, 6·1–6·3), and reductions in household air pollution (8·4%, 6·8–9·2). Interpretation Our findings show that there have been substantial but uneven declines in LRI mortality among countries between 1990 and 2017. Although improvements in indicators of sociodemographic development could explain some of these trends, changes in exposure to modifiable risk factors are related to the rates of decline in LRI mortality. No single intervention would universally accelerate reductions in health loss associated with LRIs in all settings, but emphasising the most dominant risk factors, particularly in countries with high case fatality, can contribute to the reduction of preventable deaths. Funding Bill & Melinda Gates Foundation.

Published
2020

5. Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000-17: analysis for the Global Burden of Disease Study 2017

Author

Manisha Dubey, Fatemeh Rajati, Mehran Shams-Beyranvand, Amir Khater, Reza Shirkoohi, Segun Emmanuel Ibitoye, David C. Schwebel, Milena Ilic, Kebede Embaye Gezae, Ali Akbar Fazaeli, Ronny Westerman, Taye Abuhay Zewale, Ravi Mehrotra, Sezer Kisa, Junaid Khan, Jost B. Jonas, Dian Kusuma, Marcel Ausloos, Getnet Gedefaw, Hamed Zandian, Edward J Mills, Aparna Lal, Atalay Goshu Muluneh, Leeberk Raja Inbaraj, Edgar Denova-Gutiérrez, Jacqueline Elizabeth Alcalde Rabanal, Yousef Veisani, Sharath Burugina Nagaraja, Christopher Troeger, Ismael R. Campos-Nonato, Kidane Tadesse Gebremariam, Maysaa El Sayed Zaki, Oliver J. Brady, David Laith Rawaf, Tamer H. Farag, Simin Mouodi, Hafiz Ansar Rasul Suleria, Saleh Salehi Zahabi, Soumyadeep Bhaumik, Samad Azari, Getinet Ayano, Faris Lami, Raaj Kishore Biswas, Maryam Adabi, Alaa Badawi, Saravanan Muthupandian, Amir Hasanzadeh, Martin Amogre Ayanore, Maziar Moradi-Lakeh, Mohamad-Hani Temsah, Kavumpurathu Raman Thankappan, Bineyam Taye, Nader Jafari Balalami, Hamid Yimam Hassen, Karzan Abdulmuhsin Mohammad, Paul H. Lee, Emerito Jose A. Faraon, Kewal Krishan, Muhammad Ali, Ehsan Sadeghi, Richard C. Franklin, Dara K. Mohammad, Naznin Hossain, Lal B. Rawal, Alyssa N. Sbarra, Behnam Heidari, Dietrich Rothenbacher, Hagos Tasew Atalay, Eric L. Ding, Noushin Mohammadifard, Nihal Thomas, Man Mohan Mehndiratta, Sanghamitra Pati, Addisu Melese, Niranjan Kissoon, Farzad Manafi, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, Meysam Behzadifar, Mohammad Reza Sobhiyeh, Frank B. Osei, Koku Sisay Tamirat, Yahya Salimi, Pranab Chatterjee, Gebreamlak Gebremedhn Gebremeskel, Olatunji O. Adetokunboh, Benjamin K. Mayala, Bhaskaran Unnikrishnan, Zahid A Butt, Olufemi Ajumobi, Fiseha Wadilo Wada, Shafiu Mohammed, Charles Shey Shey Wiysonge, Félix Carvalho, Masresha Tessema Anegago, Yun Jin Kim, Ai-Min Wu, Ketema Bizuwork Gebremedhin, Paulina A. Lindstedt, Ana-Laura Manda, Aziz Eftekhari, Rakhi Dandona, Mehdi Fazlzadeh, Nicole Davis Weaver, Muluken Bekele Sorrie, Marwa Rashad Salem, Kassawmar Angaw Bogale, Dongyu Zhang, Saeed Safari, Vivekanand Jha, Keivan Ahmadi, Turki Alanzi, Amir Jalali, Hamidreza Haririan, Chukwudi A Nnaji, Kebadnew Mulatu Mihretie, Lucas Guimarães Abreu, Gessessew Bugssa Hailu, Surendra Karki, Kirsten E. Wiens, Boikhutso Tlou, Soraya Siabani, Muluken Azage Yenesew, Asnakew Achaw Ayele, Ayalew Jejaw Zeleke, Osayomwanbo Osarenotor, Susanna Dunachie, Marcos Roberto Tovani-Palone, Daniel Bekele Ketema, Tissa Wijeratne, Dessalegn Ajema Berbada, André Karch, Ebrahim Babaee, Akram Pourshams, Seyyed Meysam Mousavi, Bal Govind Chauhan, Giuseppe Remuzzi, Vera Marisa Costa, Mehdi Yaseri, Tahereh Pashaei, Benn Sartorius, Helen Derara Diro, Anelisa Jaca, Mostafa Hosseini, Nikolay Ivanovich Briko, Franz Castro, Cuong Tat Nguyen, Chalachew Genet Akal, Natalie Maria Cormier, Ghulam Mustafa, Sonia Lewycka, Achala Upendra Jayatilleke, David L. Smith, Ibrahim A Khalil, Genet Melak Alamene, George C Patton, Andem Effiong, Gebrekiros Gebremichael Meles, Collins Chansa, Tsegaye Lolaso Lenjebo, Van C. Lansingh, Chabila C Mapoma, Olayinka Stephen Ilesanmi, Aso Mohammad Darwesh, Aubrey J. Levine, Miliva Mozaffor, Till Bärnighausen, Ali Rostami, André Faro, Rushdia Ahmed, Colm McAlinden, Duduzile Ndwandwe, Neeraj Bedi, Irfan Ullah, Winfried März, Rajeev Gupta, Masood Ali Shaikh, Catalina Liliana Andrei, Ali Kazemi Karyani, Shaimaa I. El-Jaafary, Abbas Mosapour, Javad Nazari, Obinna Onwujekwe, Narinder Pal Singh, Dabere Nigatu, Tanuj Kanchan, Jagdish Khubchandani, Aklilu Endalamfaw, Hajer Elkout, Michelle L. Bell, Beyene Meressa Adhena, Evanson Z. Sambala, Nelson Alvis-Guzman, Nefsu Awoke, Mohammad Ali Sahraian, Muki Shey, Christiane Dolecek, Kedir Hussein Abegaz, Syed Ather Hussain, Birhan Tamene Alemnew, Arash Etemadi, Anwar E. Ahmed, Vinay Nangia, Sachin R Atre, Roghiyeh Faridnia, Robert C. Reiner, Rajat Das Gupta, Aniruddha Deshpande, Sanjay Zodpey, Birhanu Geta, Amaha Kahsay, Muktar Beshir Ahmed, Kiana Ramezanzadeh, Jacek Jerzy Jozwiak, Chi Linh Hoang, Bahram Armoon, Manfred Accrombessi, Christopher J L Murray, Ebrahim M Yimer, Rashmi Gupta, Ahmed Omar Bali, Dadi Marami, Arash Tehrani-Banihashemi, Getnet Mengistu, Govinda Prasad Dhungana, Fereshteh Ansari, Dina Nur Anggraini Ningrum, Mu'awiyyah Babale Sufiyan, Harish Chander Gugnani, Ali S. Akanda, Satar Rezaei, Wondimeneh Shibabaw Shiferaw, Irina Filip, Mohammad Fareed, Hagos Degefa Hidru, Morteza Shamsizadeh, Mojtaba Hoseini-Ghahfarokhi, Yared A Asmare Aynalem, Gelin Xu, Zubair Kabir, Khalid A Altirkawi, Beatriz Paulina Ayala Quintanilla, Kenean Getaneh Tlaye, Devasahayam J. Christopher, Malede Mequanent Sisay, Yibeltal Alemu Bekele, Mika Shigematsu, Bryan L. Sykes, Quique Bassat, Jemal Abdu Mohammed, Seyed Mostafa Mir, Moslem Soofi, Nuruzzaman Khan, Ensiyeh Jenabi, Seyed-Mohammad Fereshtehnejad, Alireza Esteghamati, Paramjit Gill, Nathaniel J Henry, Meghnath Dhimal, Hosein Shabaninejad, Trang Huyen Nguyen, Amjad Mohamadi-Bolbanabad, Eugenio Traini, Mohammad Zamani, Arianna Maever L. Amit, Mehran Alijanzadeh, Florian Fischer, Rafael Moreira Claro, Pushpendra Kumar, Shai Linn, Lucas Earl, Haileab Fekadu Wolde, Getenet Dessie, Doris D. V. Ortega-Altamirano, John S. Ji, Moritz U. G. Kraemer, Saeed Amini, Ziad A. Memish, Aisha Elsharkawy, Ken Lee Chin, Mustafa Z. Younis, Daniel Diaz, Hebat Allah Salah A. Yousof, Seifadin Ahmed Shallo, Tomohide Yamada, Adrian Pana, Salman Rawaf, Amir Almasi-Hashiani, Platon D. Lopukhov, Alireza Rafiei, Dragos Virgil Davitoiu, Hossein Poustchi, Ayele Geleto Bali, Francesco Saverio Violante, Leonardo Roever, Giovanni Damiani, Maha El Tantawi, Nuworza Kugbey, Hadi Pourjafar, Michael R.M. Abrigo, Dinh-Toi Chu, Farkhonde Salehi, Phetole Walter Mahasha, Farnam Mohebi, Sathish Thirunavukkarasu, Dharmesh Kumar Lal, Senbagam Duraisamy, Demelash Woldeyohannes Handiso, Eleonora Dubljanin, Takeshi Fukumoto, Biruck Desalegn Yirsaw, Fakher Rahim, Jasvinder A. Singh, Jai K Das, Savita Lasrado, Ana Isabel Ribeiro, Santosh Varughese, Adnan Kisa, Laurie B. Marczak, Amira Shaheen, Peter Njenga Keiyoro, Nader Jahanmehr, Yuming Guo, Arash Ziapour, Alex Yeshaneh, Ninuk Hariyani, Seyed Sina Naghibi Irvani, Sameer Vali Gopalani, Joel M. Francis, Asmamaw Demis, Ahamarshan Jayaraman Nagarajan, Praveen Hoogar, Nicola Luigi Bragazzi, Yunquan Zhang, Yousef Mohammad, Iman El Sayed, Vafa Rahimi-Movaghar, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Marzieh Nojomi, Tewodros Eshete Wonde, Sameh Magdeldin, Anton Sokhan, Nauman Khalid, Nima Hafezi-Nejad, Ben Lacey, Luca Ronfani, James Albright, Senthilkumar Balakrishnan, Ejaz Ahmad Khan, Khanh Bao Tran, Guoqing Hu, Yousef Khader, Parvaneh Mirabi, Boris Bikbov, Feleke Mekonnen Demeke, Assefa Desalew, Yasir Waheed, Berhe Etsay Tesfay, Julio Cesar Campuzano Rincon, Ernoiz Antriyandarti, Brian J. Hall, James A Platts-Mills, Gbenga A. Kayode, Jan-Walter De Neve, Maria Jesus Rios-Blancas, Navid Manafi, Ravi Prakash Jha, Yilma Chisha Dea Geramo, Hamideh Salimzadeh, Fisaha Haile Tesfay, Abdullah Al Mamun, Ali Bijani, Hedley Quintana, Shanshan Li, Kebreab Paulos, Joan B. Soriano, Victor Adekanmbi, Oladimeji Adebayo, David Teye Doku, Brijesh Sathian, Bakhtiar Piroozi, MohammadBagher Shamsi, Netsanet Fentahun, Shymaa Enany, Ayman Grada, Salvatore Rubino, Kenji Shibuya, Norberto Perico, Sergio I. Prada, Andrea Farioli, Gebremicheal Gebreslassie Kasahun, Mohsen Afarideh, Maciej Banach, Andrey Nikolaevich Briko, Mohsen Asadi-Lari, Rakesh Lodha, David M. Pigott, Bárbara Niegia Garcia de Goulart, Hadi Hassankhani, Daniel Adane Endalew, Siamak Sabour, Yoshan Moodley, Preeti Dhillon, Dilaram Acharya, Anas M. Saad, Ibrahim Abdelmageed Ginawi, Theo Vos, Tuomo J. Meretoja, Ireneous N. Soyiri, Hasan Yusefzadeh, Mohammad Rabiee, Ajay Patle, Rahman Shiri, Girmay Teklay Weldesamuel, Sivan Yegnanarayana Iyer Saraswathy, Mekdes Tigistu Yilma, Davide Guido, Chuanhua Yu, Abdallah M. Samy, Ali Talha Khalil, Ashish Awasthi, Pascual R. Valdez, Nelson G.M. Gomes, Nejimu Biza Zepro, Taweewat Wiangkham, Anthony Masaka, Afsaneh Arzani, Ayesha Humayun, Michael Tamene Haile, Huyen Phuc Do, Krittika Bhattacharyya, Maryam Khayamzadeh, Seth Christopher Yaw Appiah, Mehdi Ahmadi, Farah Daoud, QuynhAnh P Nguyen, Suleman Atique, Sheikh Mohammed Shariful Islam, Indang Trihandini, Mario Poljak, Bartosz Miazgowski, Huda Basaleem, Rafael Alves Guimares, Mina Anjomshoa, Peng Jia, Yafeng Wang, Erkin M. Mirrakhimov, Seyed Hossein Yahyazadeh Jabbari, Itamar S. Santos, Alireza Khatony, Desalegn Tadese Mengistu, Samath D Dharmaratne, S. Mohammad Sajadi, Francisco Rogerlândio Martins-Melo, Shankar M Bakkannavar, Konrad Pesudovs, Tina Beyranvand, Liliana Preotescu, Leticia Avila-Burgos, Enrico Rubagotti, Amira Hamed Darwish, Mahdi Safdarian, Ali Yadollahpour, Vijay Kumar Chattu, Moses K. Muriithi, Azmeraw T. Amare, Si Si, Joshua Longbottom, Somayeh Bohlouli, Khaled Khatab, Masoud Behzadifar, Anusha Ganapati Bhat, G Anil Kumar, Margaret Kosek, Mona M. Khater, Reta Tsegaye Gayesa, Ghobad Moradi, Srinivas Goli, Ruth W Kimokoti, Jalal Arabloo, Kimberly B. Johnson, Andrew T Olagunju, Mowafa Househ, In-Hwan Oh, Arya Haj-Mirzaian, Desta Haftu Hayelom, Jae Il Shin, Ahmed Abdelalim, Catherine A. Welgan, Veincent Christian Filipino Pepito, Andre Rodrigues Duraes, Yuan-Pang Wang, Rosario Cárdenas, Mohammad Khazaei, Sebastian Vollmer, Xiu-Ju Zhao, Mihajlo Jakovljevic, Degu Abate, Ali S. Shalash, Davide Rasella, Melese Abate Reta, Hedayat Abbastabar, Manu Raj Mathur, Aliasghar Ahmad Kiadaliri, Ritesh G. Menezes, Molly K. Miller-Petrie, Beriwan Abdulqadir Ali, Ahmed I. Hasaballah, Joseph Frostad, Eirini Skiadaresi, Aleksandra Barac, Simon I. Hay, Deborah Carvalho Malta, Brigette F. Blacker, Carlo La Vecchia, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Zewdie Aderaw Alemu, Foad Abd-Allah, Elias Merdassa Roro, Agus Sudaryanto, Fariba Ghassemi, Behzad Karami Matin, Mohsen Naghavi, Maarten J. Postma, Chhabi Lal Ranabhat, Maheswar Satpathy, Mahesh P A, Carlos Miguel Rios González, Pallab K. Maulik, Amir Kasaeian, Ali H. Mokdad, Alemayehu Toma Mena, Tamirat Tesfaye Dasa, Abdur Razzaque Sarker, Andre M. N. Renzaho, Muhammad Aziz Rahman, Ali Kabir, Josephine W. Ngunjiri, Aberash Abay Tassew, Kala M. Mehta, Ionut Negoi, Hosni Salem, Hesham M. Al-Mekhlafi, Sharareh Eskandarieh, Rufus A. Adedoyin, Saleem M Rana, Engida Yisma, Sahel Valadan Tahbaz, Hossein Farzam, Krishna K. Aryal, Lalit Dandona, Masoud Moradi, Juan Sanabria, Gebre Teklemariam Demoz, Naser Mohammad Gholi Mezerji, Shirin Djalalinia, Suraj Bhattarai, Ammas Siraj Mohammed, Claudiu Herteliu, Dawit Zewdu Wondafrash, Mohsen Bayati, Arvin Haj-Mirzaian, Gulfaraz Khan, Mostafa Leili, Nasir Salam, Ehsan Khodamoradi, Jean Jacques Noubiap, Vahid Alipour, Mohammad Ali Mansournia, Rajesh Sagar, Jagadish Rao Padubidri, Manasi Kumar, Mehdi Sharif, Fatemeh Heydarpour, Navid Rabiee, Gvs Murthy, Hamed Kalani, Mayowa O. Owolabi, Claudio Alberto Davila, Oluchi Okpala, Shivakumar K.M. Kondlahalli, Mathew M. Baumann, Bereket Duko Adema, Lorenzo Monasta, Paul S. F. Yip, Mohammad Hossein Khosravi, Rizwan Suliankatchi Abdulkader, Ibrahim Abdollahpour, Dhirendra N Sinha, Farid Najafi, Kebede Deribe, Paula Moraga, Mehedi Hasan, Mohammad Moradi-Joo, Melkamu Merid Mengesha, Temesgen Yihunie Akalu, Vishnu Renjith, Syed Mohamed Aljunid, Zemenu Tadesse Tessema, Amir Radfar, Nuno Taveira, Masoud Foroutan, Demelash Abewa Elemineh, Chinwe Juliana Iwu, Kamarul Imran Musa, Getaneh Alemu Abebe, Farshad Pourmalek, Olatunde Aremu, Mohammad Reza Salahshoor, Derrick A Bennett, Ahmad Daryani, Alebachew Fasil Ashagre, Apurba Shil, Narayan Bahadur Mahotra, Nelson J. Alvis-Zakzuk, Lauren E. Schaeffer, Alexandre C. Pereira, Mehdi Naderi, Mehdi Hosseinzadeh, Rovshan Khalilov, Ai Koyanagi, Salman Khazaei, Jennifer Rickard, Ali Almasi, Sandra B. Munro, Carlos Zambrana-Torrelio, Naohiro Yonemoto, Ahmad Ghashghaee, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), Instituto de Saúde Pública da Universidade do Porto, Local Burden Dis Diarrhoea, Department of Earth Observation Science, UT-I-ITC-ACQUAL, Faculty of Geo-Information Science and Earth Observation, GeoHealth, Reiner, Robert C, Wiens, Kirsten E, Deshpande, Aniruddha, Baumann, Mathew M, Adema, Bereket Duko, Yirsaw, Biruck Desalegn, Yisma, Engida, Hay, Simon I, Local Burden of Disease Diarrhoea Collaborators, Tampere University, Health Sciences, University of Helsinki, Institute for Molecular Medicine Finland, Clinicum, HUS Comprehensive Cancer Center, Local Burden of Disease Diarrhoea Collaborator, and Violante FS

Subjects
Low income countries, medicine.medical_treatment, 030204 cardiovascular system & hematology, Global Health, THERAPY, Global Burden of Disease, 0302 clinical medicine, Prevalence, Global health, Medicine, WATER, 030212 general & internal medicine, Children, 11 Medical and Health Sciences, Incidence, Mortality rate, Incidence (epidemiology), 1. No poverty, General Medicine, 3142 Public health care science, environmental and occupational health, Diarrhoea, 3. Good health, Child, Preschool, Middle income countries, A990 Medicine and Dentistry not elsewhere classified, TERRITORIES, Life Sciences & Biomedicine, Infants, Diarrhea, AFRICA, medicine.medical_specialty, Childhood deaths, RJ, sanitation, Developing country, Childhood diarrhoeal morbidity, ITC-HYBRID, 03 medical and health sciences, Medicine, General & Internal, General & Internal Medicine, Environmental health, SYSTEMATIC ANALYSIS, Life Science, Humans, Healthcare Disparities, Oral rehydration therapy, Risk factor, hand washing, Developing Countries, Disease burden, Global Nutrition, Wereldvoeding, Science & Technology, SEX-SPECIFIC MORTALITY, business.industry, CHOLERA, Public health, Bayes Theorem, diarrheal disease, Local Burden of Disease Diarrhoea Collaborators, ITC-ISI-JOURNAL-ARTICLE, NA, Human medicine, Diarrea, business
Abstract

Background: Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea incidence and mortality is attributable to interventions that protect children, prevent infection, and treat disease. Identifying subnational regions with the highest burden and mapping associated risk factors can aid in reducing preventable childhood diarrhoea. Methods: We used Bayesian model-based geostatistics and a geolocated dataset comprising 15 072 746 children younger than 5 years from 466 surveys in 94 LMICs, in combination with findings of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, to estimate posterior distributions of diarrhoea prevalence, incidence, and mortality from 2000 to 2017. From these data, we estimated the burden of diarrhoea at varying subnational levels (termed units) by spatially aggregating draws, and we investigated the drivers of subnational patterns by creating aggregated risk factor estimates. Findings: The greatest declines in diarrhoeal mortality were seen in south and southeast Asia and South America, where 54·0% (95% uncertainty interval [UI] 38·1-65·8), 17·4% (7·7-28·4), and 59·5% (34·2-86·9) of units, respectively, recorded decreases in deaths from diarrhoea greater than 10%. Although children in much of Africa remain at high risk of death due to diarrhoea, regions with the most deaths were outside Africa, with the highest mortality units located in Pakistan. Indonesia showed the greatest within-country geographical inequality; some regions had mortality rates nearly four times the average country rate. Reductions in mortality were correlated to improvements in water, sanitation, and hygiene (WASH) or reductions in child growth failure (CGF). Similarly, most high-risk areas had poor WASH, high CGF, or low oral rehydration therapy coverage. Interpretation: By co-analysing geospatial trends in diarrhoeal burden and its key risk factors, we could assess candidate drivers of subnational death reduction. Further, by doing a counterfactual analysis of the remaining disease burden using key risk factors, we identified potential intervention strategies for vulnerable populations. In view of the demands for limited resources in LMICs, accurately quantifying the burden of diarrhoea and its drivers is important for precision public health. This work was primarily supported by a grant from the Bill & Melinda Gates Foundation (OPP1132415). S Aljunid reports additional funding from the International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia and Department of Health Policy and Management, Faculty of Public Health, Kuwait University for the approval and support to participate in this research project outside of the study. A Awasthi is supported by the Department of Science and Technology, Government of India, New Delhi, through the INSPIRE Faculty Program outside of the study. A Badawi reports additional funding from the Public Health Agency of Canada outside of the study. A Barac reports additional funding from the Project of Ministry of Education, Science and Technology of the Republic of Serbia (no III45005) outside of the study. T Bärnighausen reports additional funding by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research outside of the study. F Carvalho and E Fernandez report additional funding from the Portuguese national funds (UID/MULTI/04378/2019 and UID/QUI/50006/2019) outside of the study. V M Costa reports additional funding from Fundação da Ciência e Tecnologia (FCT) for her grant (SFRH/BPD/110001/2015), which was funded by national funds through FCT – Fundação para a Ciência e a Tecnologia, IP, under the Norma Transitória – DL57/2016/CP1334/CT0006 outside of the study. J De Neve reports additional funding from the Alexander von Humboldt Foundation outside of the study. K Deribe reports additional funding from the Wellcome Trust (grant number 201900) as part of his International Intermediate Fellowship outside of the study. D Endalew and M Moradi report additional funding from Wolkite University. M Ausloos, C Herteliu, and A Pana report additional funding from the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI (project number PN-III-P4-ID-PCCF-2016-0084) outside of the study. C Herteliu reports additional funding from the European Fund for Regional Development through Operational Program for Competitiveness (Project ID P_40_382) and the European Fund for Regional Development, through InterReg Romania-Hungary (project code EMS ROHU 217) outside of the study. P Hoogar reports additional funding from the Centre for Holistic Development and Research (CHDR), Kalaghatagi and The Department of Studies in Anthropology, Karnatak University, D S Islam reports additional funding from the National Heart Foundation of Australia and the Institute for Physical Activity and Nutrition, Deakin University outside of the study. A Khatony reports additional funding from the Clinical Research Development Center of Imam Reza Hospital in Kermanshah outside of the study. J Khubchandani reports additional funding from Merck Research Laboratories outside of the study. K Krishan reports additional funding from the UGC Center of Advanced Study (CAS II) awarded to the Department of Anthropology, Panjab University, Chandigarh, India outside of the study. M Kumar reports additional funding from the Fogarty Foundation/NIH through a K43 award (TW010716-01A1) outside of the study. B Lacey reports additional funding from the National Institute for Health Research Oxford Biomedical Research Centre and the British Heart Foundation Centre of Research Excellence (Oxford, UK) outside of the study. A M Samy reports additional funding from the Egyptian Fulbright Mission Program (EFMP) outside of the study. S Seyedmousavi reports additional funding from the Intramural Program of National Institute of Health Clinical Center, Bethesda, MD, USA outside of the study. M Shey reports additional funding from the Wellcome Trust Kenji Shibuya reports additional funding from Japan's Ministry of Health, Labour and Welfare and Japan's Ministry of Education, Culture, Sport, Science and Technology outside of the study. M Sobhiyeh reports additional funding from the Clinical Research Development Center of Imam Reza Hospital, Kermanshah University of Medical Sciences outside of the study. J Soriano reports additional funding from Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain outside of the study. N Taveira reports additional funding from the LIFE study (RIA2016MC-1615) of the European and Developing Countries Clinical Trials Partnership (EDCTP) program supported by the European Union outside of the study. B Unnikrishnan reports additional funding from the Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India outside of the study. T Wijeratne reports additional funding from the Department of Medicine, Faculty of Medicine, University of Rajarata, Saliyapura, Sri Lanka outside of the study. C S Wiysonge reports additional funding from the South African Medical Research Council and the National Research Foundation of South Africa outside of the study.

Published
2020

6. Prevalence and attributable health burden of chronic respiratory diseases, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Author

Mohsen Naghavi, Maarten J. Postma, Mahesh P A, Milena Santric-Milicevic, Barbora de Courten, Parvaiz A Koul, Elias Merdassa Roro, Marek Majdan, Ali H. Mokdad, Mihaela Hostiuc, Félix Carvalho, Rufus A. Adedoyin, Miriam Levi, Ejaz Ahmad Khan, Rakhi Dandona, Mohamad-Hani Temsah, Catalina Liliana Andrei, Benn Sartorius, Gebre Teklemariam Demoz, Derrick A Bennett, Ahmad Daryani, Paulo A. Lotufo, Fereshteh Ansari, Elissa M. Abrams, Luke D. Knibbs, Seyyed Meysam Mousavi, Azeem Majeed, Tomislav Mestrovic, Rajeev Gupta, Irina Filip, Leonardo Roever, G.K. Mini, Lorainne Tudor Car, Ghulam Mustafa, Josip Car, Lalit Dandona, Masoud Moradi, Molly R Nixon, Mohammad Zamani, Babak Moazen, Devasahayam J. Christopher, Chi Linh Hoang, Aaron J Cohen, Hossein Poustchi, Luca Ronfani, Sheikh Mohammed Shariful Islam, Nefsu Awoke, Miguel Tortajada-Girbés, Khalid A Altirkawi, Justin R. Ortiz, Adane Teshome Kefale, Shailesh Advani, Alireza Rafiei, Kristina E. Rudd, Tim Driscoll, Yousef Khader, Heather J. Zar, Josep M. Antó, Milena Ilic, Fakher Rahim, Jost B. Jonas, Trang Huyen Nguyen, Yonatal Mesfin Tefera, Simon I. Hay, Aloke Gopal Ghoshal, Adnan Kisa, Ranjani Somayaji, Gholamreza Roshandel, Smita Pakhale, Francesco Saverio Violante, Monika Sawhney, Eyal Oren, Ali Bijani, Gebrekiros Gebremichael Meles, Hajer Elkout, Shanshan Li, Michael Soljak, Masoud Foroutan, Narayan Bahadur Mahotra, Mina Anjomshoa, Jasvinder A. Singh, Mika Shigematsu, Abdel Douiri, Naohiro Yonemoto, Amir Kasaeian, Lorenzo Monasta, Hagazi Gebre Meles, Rupak Desai, Hai Quang Pham, Feleke Mekonnen Demeke, Marissa B Reitsma, Samath D Dharmaratne, Amr Jamal, Miguel Ángel García-Gordillo, Seyed Sina Naghibi Irvani, Michael K. Hole, Aman Yesuf Endries, Vinay Gupta, Mehdi Naderi, Tham Thi Le, Houman Goudarzi, Hamid Yimam Hassen, Siamak Sabour, Theo Vos, Anurag Agrawal, Ireneous N. Soyiri, Kathleen S Sachiko Berfield, Charles D.A. Wolfe, Jobert Richie Nansseu, Robert C. Reiner, Carlo La Vecchia, Michael Brauer, Jagdish Khubchandani, Alaa Badawi, Sezer Kisa, Basema Saddik, Amir Hasanzadeh, H. Dean Hosgood, Berhe Etsay Tesfay, Ibtihal Fadhil, Ketema Bizuwork Gebremedhin, Ai Koyanagi, Maheswar Satpathy, James Leigh, Si Si, Gregory R. Wagner, Eduarda Fernandes, Huong Lan Thi Nguyen, Isabela M. Benseñor, Tommi Vasankari, Gebreamlak Gebremedhn Gebremeskel, Andrew T Olagunju, Moslem Soofi, Jalal Arabloo, Muhammad Aziz Rahman, Mowafa Househ, Amir Radfar, Gebremicheal Gebreslassie Kasahun, Tara Ballav Adhikari, Songhomitra Panda-Jonas, Gessessew Bugssa Hailu, Komal Saleem, Bach Xuan Tran, Lal B. Rawal, Jee-Young Jasmine Choi, Hadi Pourjafar, Robert S. Bernstein, Ghobad Moradi, Farnam Mohebi, Mariam Molokhia, Kamarul Imran Musa, Elham Ahmadian, Pascual R. Valdez, Irfan Ullah, Ritesh G. Menezes, Dawit Zewdu Wondafrash, Olayinka Stephen Ilesanmi, Masood Ali Shaikh, Richard F. Gillum, Aziz Sheikh, Eun-Kee Park, Virendra Singh, Aziz Eftekhari, Yogesh Sabde, Florian Fischer, Krittika Bhattacharyya, Syed Mohamed Aljunid, Alemayehu Toma, Ruxandra Irina Negoi, Kebede Embaye Gezae, Abadi Kahsu Gebre, Abdullah Al Mamun, Junaid Khan, Yuming Guo, Parkes J Kendrick, Reza Malekzadeh, Bruno Piassi Sao Jose, Mohammad Hifz Ur Rahman, Lidia Morawska, Soraya Siabani, Tinuke O Olagunju, Zahid A Butt, Ronny Westerman, Eyasu Ejeta Duken, Khanh Bao Tran, Yousef Veisani, Getachew Mullu Kassa, Erkin M. Mirrakhimov, Miloje Savic, Anh Kim Dang, Vinay Nangia, Job F M van Boven, Adam Belay Wondmieneh, Alan D. Lopez, G Anil Kumar, Navid Manafi, Andre Pascal Kengne, Joan B. Soriano, Luis Camera, Seok Jun Yoon, Paramjit Gill, Yun Jin Kim, Seyyede Masoume Athari, Gurudatta Naik, Sadaf G. Sepanlou, Sanjeev Nair, Jarnail Singh Thakur, André Faro, Javad Nazari, Gene Bukhman, Nelson Alvis-Guzman, Mayowa O. Owolabi, Lorenzo G. Mantovani, Nobuyuki Horita, Zubair Kabir, Felix Akpojene Ogbo, Birhanu Geta Meharie, Daniel Diaz, Adrian Pana, Salman Rawaf, Mihajlo Jakovljevic, Ted R. Miller, Savita Lasrado, Joseph Adel Mattar Banoub, Fares Alahdab, Jan-Walter De Neve, Carlos A Castañeda-Orjuela, Saeed Safari, Farzad Manafi, Marco Vacante, Katherine R. Paulson, Hamidreza Komaki, Reza Shirkoohi, Young Eun Kim, Duduzile Ndwandwe, Nahla Anber, Ravi Prakash Jha, Farshad Farzadfar, Abdallah M. Samy, Richard Ofori-Asenso, Shafiu Mohammed, Paolo Lauriola, Fabiana Madotto, Yunquan Zhang, Qing Lan, David Laith Rawaf, Zoubida Zaidi, Karzan Abdulmuhsin Mohammad, Juan Jesus Carrero, Morteza Abdullatif Khafaie, Seyyed Shamsadin Athari, Cuong Tat Nguyen, UAM. Departamento de Medicina, Instituto de Investigación Sanitaria Hospital Universitario de La Princesa (IIS-IP), Soriano, J, Kendrick, P, Paulson, K, Gupta, V, Abrams, E, Adedoyin, R, Adhikari, T, Advani, S, Agrawal, A, Ahmadian, E, Alahdab, F, Aljunid, S, Altirkawi, K, Alvis-Guzman, N, Anber, N, Andrei, C, Anjomshoa, M, Ansari, F, Anto, J, Arabloo, J, Athari, S, Awoke, N, Badawi, A, Banoub, J, Bennett, D, Bensenor, I, Berfield, K, Bernstein, R, Bhattacharyya, K, Bijani, A, Brauer, M, Bukhman, G, Butt, Z, Camera, L, Car, J, Carrero, J, Carvalho, F, Castaneda-Orjuela, C, Choi, J, Christopher, D, Cohen, A, Dandona, L, Dandona, R, Dang, A, Daryani, A, de Courten, B, Demeke, F, Demoz, G, De Neve, J, Desai, R, Dharmaratne, S, Diaz, D, Douiri, A, Driscoll, T, Duken, E, Eftekhari, A, Elkout, H, Endries, A, Fadhil, I, Faro, A, Farzadfar, F, Fernandes, E, Filip, I, Fischer, F, Foroutan, M, Garcia-Gordillo, M, Gebre, A, Gebremedhin, K, Gebremeskel, G, Gezae, K, Ghoshal, A, Gill, P, Gillum, R, Goudarzi, H, Guo, Y, Gupta, R, Hailu, G, Hasanzadeh, A, Hassen, H, Hay, S, Hoang, C, Hole, M, Horita, N, Hosgood, H, Hostiuc, M, Househ, M, Ilesanmi, O, Ilic, M, Irvani, S, Islam, S, Jakovljevic, M, Jamal, A, Jha, R, Jonas, J, Kabir, Z, Kasaeian, A, Kasahun, G, Kassa, G, Kefale, A, Kengne, A, Khader, Y, Khafaie, M, Khan, E, Khan, J, Khubchandani, J, Kim, Y, Kisa, S, Kisa, A, Knibbs, L, Komaki, H, Koul, P, Koyanagi, A, Kumar, G, Lan, Q, Lasrado, S, Lauriola, P, La Vecchia, C, Le, T, Leigh, J, Levi, M, Li, S, Lopez, A, Lotufo, P, Madotto, F, Mahotra, N, Majdan, M, Majeed, A, Malekzadeh, R, Mamun, A, Manafi, N, Manafi, F, Mantovani, L, Meharie, B, Meles, H, Meles, G, Menezes, R, Mestrovic, T, Miller, T, Mini, G, Mirrakhimov, E, Moazen, B, Mohammad, K, Mohammed, S, Mohebi, F, Mokdad, A, Molokhia, M, Monasta, L, Moradi, M, Moradi, G, Morawska, L, Mousavi, S, Musa, K, Mustafa, G, Naderi, M, Naghavi, M, Naik, G, Nair, S, Nangia, V, Nansseu, J, Nazari, J, Ndwandwe, D, Negoi, R, Nguyen, T, Nguyen, C, Nguyen, H, Nixon, M, Ofori-Asenso, R, Ogbo, F, Olagunju, A, Olagunju, T, Oren, E, Ortiz, J, Owolabi, M, P A, M, Pakhale, S, Pana, A, Panda-Jonas, S, Park, E, Pham, H, Postma, M, Pourjafar, H, Poustchi, H, Radfar, A, Rafiei, A, Rahim, F, Rahman, M, Rawaf, S, Rawaf, D, Rawal, L, Reiner, R, Reitsma, M, Roever, L, Ronfani, L, Roro, E, Roshandel, G, Rudd, K, Sabde, Y, Sabour, S, Saddik, B, Safari, S, Saleem, K, Samy, A, Santric-Milicevic, M, Sao Jose, B, Sartorius, B, Satpathy, M, Savic, M, Sawhney, M, Sepanlou, S, Shaikh, M, Sheikh, A, Shigematsu, M, Shirkoohi, R, Si, S, Siabani, S, Singh, V, Singh, J, Soljak, M, Somayaji, R, Soofi, M, Soyiri, I, Tefera, Y, Temsah, M, Tesfay, B, Thakur, J, Toma, A, Tortajada-Girbes, M, Tran, K, Tran, B, Tudor Car, L, Ullah, I, Vacante, M, Valdez, P, van Boven, J, Vasankari, T, Veisani, Y, Violante, F, Wagner, G, Westerman, R, Wolfe, C, Wondafrash, D, Wondmieneh, A, Yonemoto, N, Yoon, S, Zaidi, Z, Zamani, M, Zar, H, Zhang, Y, Vos, T, GBD Chronic Respiratory Disease Collaborator, Violante FS, GBD Chronic Respiratory Disease Collaborators, Collaborators, GBD Chronic Respiratory Disease, Groningen Research Institute for Asthma and COPD (GRIAC), Value, Affordability and Sustainability (VALUE), and Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET)

Subjects
Male, Respiratory diseases, Respiratory Tract Diseases, Disease, Chronic respiratory diseases, Global Burden of Disease, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Cost of Illness, 11. Sustainability, METABOLIC RISKS, EPIDEMIOLOGY, 030212 general & internal medicine, Child, Cause of death, Aged, 80 and over, COPD, DALY, Chronic obstructive pulmonary disease, Mortality rate, Respiratory disease, 1. No poverty, Age Factors, Middle Aged, Death causes, 3. Good health, PREVALENCE, Health risks, Child, Preschool, COMPARATIVE RISK-ASSESSMENT, Female, death and disability worldwide, Quality-Adjusted Life Years, TERRITORIES, BURDEN, growth in absolute numbers, Pulmonary and Respiratory Medicine, Adult, ADJUSTED LIFE-YEARS, Health burdens, Adolescent, Medicina, 195 COUNTRIES, chronic respiratory diseases, Article, 1117 Public Health and Health Services, 03 medical and health sciences, Young Adult, Life Expectancy, Sex Factors, Burden of Disease, Respiratory disease, Sarcoidosis, Pulmonary, Environmental health, medicine, Disability-adjusted life year, Humans, EXPOSURE, Risk factor, Mortality, Aged, per-capita basis, business.industry, DISABILITY, Infant, Newborn, Infant, 1103 Clinical Sciences, asthma, medicine.disease, Asthma, Years of potential life lost, 030228 respiratory system, Risk factors, 13. Climate action, Systematic analyses, Chronic Disease, INJURIES, Human medicine, Pneumoconiosis, Morbidity, business, Lung Diseases, Interstitial, 1199 Other Medical and Health Sciences
Abstract

Artículo con numerosos autores. Sólo se hace referencia al primero que coincide con el de la UAM y al colectivo, Background Previous attempts to characterise the burden of chronic respiratory diseases have focused only on specific disease conditions, such as chronic obstructive pulmonary disease (COPD) or asthma. In this study, we aimed to characterise the burden of chronic respiratory diseases globally, providing a comprehensive and up-to-date analysis on geographical and time trends from 1990 to 2017. Methods Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, we estimated the prevalence, morbidity, and mortality attributable to chronic respiratory diseases through an analysis of deaths, disability-adjusted life-years (DALYs), and years of life lost (YLL) by GBD super-region, from 1990 to 2017, stratified by age and sex. Specific diseases analysed included asthma, COPD, interstitial lung disease and pulmonary sarcoidosis, pneumoconiosis, and other chronic respiratory diseases. We also assessed the contribution of risk factors (smoking, second-hand smoke, ambient particulate matter and ozone pollution, household air pollution from solid fuels, and occupational risks) to chronic respiratory disease-attributable DALYs. Findings In 2017, 544·9 million people (95% uncertainty interval [UI] 506·9–584·8) worldwide had a chronic respiratory disease, representing an increase of 39·8% compared with 1990. Chronic respiratory disease prevalence showed wide variability across GBD super-regions, with the highest prevalence among both males and females in high-income regions, and the lowest prevalence in sub-Saharan Africa and south Asia. The age-sex-specific prevalence of each chronic respiratory disease in 2017 was also highly variable geographically. Chronic respiratory diseases were the third leading cause of death in 2017 (7·0% [95% UI 6·8–7·2] of all deaths), behind cardiovascular diseases and neoplasms. Deaths due to chronic respiratory diseases numbered 3 914 196 (95% UI 3 790 578–4 044 819) in 2017, an increase of 18·0% since 1990, while total DALYs increased by 13·3%. However, when accounting for ageing and population growth, declines were observed in age-standardised prevalence (14·3% decrease), agestandardised death rates (42·6%), and age-standardised DALY rates (38·2%). In males and females, most chronic respiratory disease-attributable deaths and DALYs were due to COPD. In regional analyses, mortality rates from chronic respiratory diseases were greatest in south Asia and lowest in sub-Saharan Africa, also across both sexes. Notably, although absolute prevalence was lower in south Asia than in most other super-regions, YLLs due to chronic respiratory diseases across the subcontinent were the highest in the world. Death rates due to interstitial lung disease and pulmonary sarcoidosis were greater than those due to pneumoconiosis in all super-regions. Smoking was the leading risk factor for chronic respiratory disease-related disability across all regions for men. Among women, household air pollution from solid fuels was the predominant risk factor for chronic respiratory diseases in south Asia and sub-Saharan Africa, while ambient particulate matter represented the leading risk factor in southeast Asia, east Asia, and Oceania, and in the Middle East and north Africa super-region. Interpretation Our study shows that chronic respiratory diseases remain a leading cause of death and disability worldwide, with growth in absolute numbers but sharp declines in several age-standardised estimators since 1990. Premature mortality from chronic respiratory diseases seems to be highest in regions with less-resourced health systems on a per-capita basis, Bill & Melinda Gates Foundation.

Published
2020

7. Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000-17

Author

Ninuk Hariyani, Benjamin Uzochukwu, Anas M. Saad, Sivan Yegnanarayana Iyer Saraswathy, Amirhossein Sahebkar, Behzad Karami Matin, Abdallah M. Samy, Roman Topor-Madry, Nelson G.M. Gomes, Afsaneh Arzani, Simin Liu, Maryam Khayamzadeh, Ejaz Ahmad Khan, Asmamaw Bizuneh Demis, Anelisa Jaca, Amir Kasaeian, Fereshteh Ansari, Abdur Razzaque Sarker, Ali Kabir, Jorge Cano, Marcos Roberto Tovani-Palone, Tufa Kolola, Josephine W. Ngunjiri, Roghiyeh Faridnia, Kedir Hussein Abegaz, Hosni Salem, Sharareh Eskandarieh, Norberto Perico, Sergio I. Prada, Fisaha Haile Tesfay, Jai K Das, Ana Isabel Ribeiro, Sameer Vali Gopalani, Dessalegn Haile, Shivakumar Km Marulasiddaiah M. KMShivakumar, Narayan Prasad, Pranab Chatterjee, Shafiu Mohammed, Ravi Prakash Jha, Xiu Ju George Zhao, Farshad Farzadfar, Ahmad Daryani, Pramesh Raj Ghimire, Abbas Mosapour, Ebrahim Babaee, Rajat Das Gupta, Jean Jacques Noubiap, Daniel Bekele Ketema, Teshome Bekele Elema I, Erkin M. Mirrakhimov, Seyed Hossein Yahyazadeh Jabbari, Muktar Beshir Ahmed, Wondimeneh Shibabaw Shiferaw, Mehran Asadi-Aliabadi, Mohamed M. Gad, Eugenio Traini, Milena Santric-Milicevic, Bakhtiar Piroozi, Mohsen Afarideh, Duduzile Ndwandwe, Ibrahim Abdollahpour, Aisha Elsharkawy, Bárbara Niegia Garcia de Goulart, Soufiane Boufous, Obinna Onwujekwe, Seyyed Meysam Mousavi, Azeem Majeed, Meghnath Dhimal, Bruno F. Sunguya, Daniel Adane Endalew, Hosein Shabaninejad, Siddhesh Zadey, Takahiro Tabuchi, Gebrekiros Gebremichael Meles, Davide Guido, Trang Huyen Nguyen, Yonatal Mesfin Tefera, Hala Elhabashy, Devasahayam J. Christopher, Malede Mequanent Sisay, Davide Rasella, Hedayat Abbastabar, Maziar Moradi-Lakeh, Anthony Masaka, Wagaye Fentahun Chanie, B. Suresh Kumar Shetty, Matiwos Soboka Daba, Tesfaye Yitna Yitna Chichiabellu, Arianna Maever L. Amit, Tomohide Yamada, Alireza Rafiei, Reinhard Busse, Abdullah Al Mamun, Genet Melak Alamene, George C Patton, Andem Effiong, Rushdia Ahmed, Jagadish Rao Padubidri, Mohamad-Hani Temsah, Nizal Sarrafzadegan I, Francesco Saverio Violante, Monika Sawhney, Eyal Oren, Kimberly B. Johnson, Benn Sartorius, Shirin Djalalinia, Mohsen Bayati, Merhawi Gebremedhin Tekle, Navid Rabiee, Javad Nazari, Krishna K. Aryal, Kavumpurathu Raman Thankappan, Yoshan Moodley, Anh Kim Dang, Mohammad Khazaei, Parvaiz A Koul, Edson Serván-Mori, Foad Abd-Allah, Seyed Mohammad Riahi, Nader Jahanmehr, Yuming Guo, Sonia Saxena, Bayu Begashaw Bekele, Hagos Degefa de Hidru I, Enayatollah Homaie Rad, Richard C. Franklin, Dara K. Mohammad, Naznin Hossain, Oliver J. Brady, Natalie Maria Cormier, Ghulam Mustafa, Samiah Alam, Guoqing Hu, Yousef Khader, Mohsen Mazidi, Hamed Kalani, Hamideh Salimzadeh, Mayowa O. Owolabi, Ali Bijani, Getu Debalkie Demissie, Tsegaye Lolaso Lenjebo, German Martinez, Elias Merdassa Roro, Hamidreza Komaki, Giovanni Damiani, Nelson Alvis-Guzman, Reza Shirkoohi, Aditya Prasad Dash, Benny Antony, Cheru Tesema Leshargie, Josip Car, Turki Alanzi, Amir Jalali, Shahin Soltani, Arvin Haj-Mirzaian, John S. Ji, Nima Hafezi-Nejad, S. Mohammad Sajadi, Khalid A Altirkawi, Shanshan Li, Hunduma Amensisa Amensisa Bojia I, Estifanos Baye, Hany Aref, Kebreab Paulos, Francisco Rogerlândio Martins-Melo, Shankar M Bakkannavar, Felix Lam, Themba G.G. Ginindza, Behnam Heidari, Chukwudi A Nnaji, Kebadnew Mulatu Mihretie, Mostafa Leili, Sohail Ahmad, Babak Moazen, Samad Azari, Feleke Gebremeskel W, Jacqueline Elizabeth Alcalde-Rabanal, Khanh Bao Tran, Okechukwu S Ogah, Bruno Ramos Nascimento, Tefera Chane Mekonnen, Irina Filip, Bogdan Oancea, Lalit Dandona, Desalegn Markos Shifti, Nasir Salam, Binyam Minuye Birihane, Mohammad Ali Mansournia, Mohammad Ebrahimi Kalan, Sheetal D. Lad, Michael R.M. Abrigo, Ken Lee Chin, Masoud Moradi, Temesgen Yihunie Akalu, Behzad Heibati, Ole Frithjof Norheim, Man Mohan Mehndiratta, Mahya Beheshti, Ali Yadollahpour, Gelin Xu, Siamak Sabour, Neda Izadi, Carlos Culquichicón, Tuomo J. Meretoja, Ireneous N. Soyiri, Jacob Olusegun Olusanya, Félix Carvalho, Hamid Yimam Hassen, Dereje Bayissa Demissie, Yun Jin Kim, Rajesh Sagar, Fakher Rahim, Catrin E. Moore, Thomas R. Hird, Amjad Mohamadi-Bolbanabad, Naser Mohammad Gholi Mezerji, Ahamarshan Jayaraman Nagarajan, Anton Sokhan, Faris Lami, Masoud Behzadifar, Ritesh G. Menezes, Amira Hamed Darwish, Mohammad Zamani, Tesleem Kayode Babalola, Navid Manafi, Charles Shey Wiysonge, Diego Augusto Santos Silva, Daniel Diaz, Eleonora Dubljanin, Soraya Nouraei Motlagh, Suraj Bhattarai, Getasew Taddesse Worku, Noore Alam, Jasvinder A. Singh, Catalina Liliana Andrei, Ali Kazemi Karyani, Robert C. Reiner, Mohammedaman Mama Hussen, Fatemeh Heydarpour, Nuruzzaman Khan I, Bach Xuan Tran, Lal B. Rawal, Bereket Duko, Joemer C. Maravilla, Rakhi Dandona, Sandra B. Munro, Jae Il Shin, Julia Moreira Pescarini, Claudiu Herteliu, Ahmed Abdelalim, Manasi Kumar, Pushpendra Kumar, Saleem Muhammad Rana, Hedley Quintana, Akram Pourshams, Franz Castro, Muhammad Aziz Rahman, Beyene Meressa Adhena, Aberash Abay Tasew, Linda Morales, Dawit Zewdu Wondafrash, Wasiq Faraz Rawasia, David Laith Rawaf, Zoubida Zaidi, Tomislav Mestrovic, Rajeev Gupta, Seyyede Masoume Athari, Peter Njenga Keiyoro, Andrea Werdecker, Santi Martini, Fatemeh Rajati, Andre Pascal Kengne, Victor Adekanmbi, Seid Tiku Mereta, Yared Asmare Aynalem, Kewal Krishan, Marzieh Nojomi, Yves Miel H Zuniga, Mohammad Reza Sobhiyeh, Frank B. Osei, Nefsu Awoke, Randah R. Hamadeh, G. K. Mini, Edris Hasanpoor, Ayele Geleto Bali, Moslem Soofi, Prabhat Lamichhane, Peter Azzopardi, Amir Khater, G Anil Kumar, Catherine A. Welgan, Abraham Getachew Kelbore, Jaifred Christian F. Lopez, Senthilkumar Balakrishnan, Mohammad Ali Sahraian, Ahmed I. Hasaballah, Virendra Singh, Arash Ziapour, Zahid A Butt, Hebat Allah Salah A. Yousof, Tewodros Eshete Wonde, Sanjay Zodpey, Amaha Kahsay, Achala Upendra Jayatilleke, Segun Emmanuel Ibitoye, Beriwan Abdulqadir Ali, Simin Mouodi, Salman Rawaf, Iqbal R. F. Elyazar, Ai-Min Wu, Seyed Sina Naghibi Irvani, Yasir Waheed, Delia Hendrie, Hadi Pourjafar, Farnam Mohebi, Naohiro Yonemoto, Ahmad Ghashghaee, Veincent Christian Filipino Pepito, Paulina A. Lindstedt, Nauman Khalid, Sezer Kisa, Chi Linh Hoang, Niranjan Kissoon, Kindie Fentahun Muchie, Valery L. Feigin, Mathew M. Baumann, Alemayehu Toma, Andre Rodrigues Duraes, Benjamin B. Massenburg, Santosh Varughese, Yuan-Pang Wang, Ingan Ukur Tarigan, Ali Kiadaliri, Hamed Zandian, Demelash Woldeyohannes Handiso, Hassan Magdy Abd El Razek, Ketema Bizuwork Gebremedhin, Hafiz Ansar Rasul Suleria, Oluchi Ezekannagha, Getinet Ayano, Bolajoko O. Olusanya, Manu Raj Mathur, Manfred Accrombessi, Christopher J L Murray, Moritz U. G. Kraemer, Saeed Amini, Ziad A. Memish, Yousef Mohammad, Luis Camera, Ernoiz Antriyandarti, Ronny Westerman, Meghdad Pirsaheb, Negar Rezaei, Ted R. Miller, Aziz Eftekhari, Nevine El Nahas, Sebastian Vollmer, Sanjay Basu, Hesham M. Al-Mekhlafi, D. R. Mahadeshwara Prasad, Rufus A. Adedoyin, Miliva Mozaffor I, Mihiretu Kebede, Preeti Dhillon, Dilaram Acharya, Iman El Sayed, Narendar Manohar, Paul S. F. Yip, Ben Lacey, Felix Akpojene Ogbo, Adrian Davis, Dinh-Toi Chu, Ranjani Somayaji, Raaj Kishore Biswas, Taddese Alemu Zerfu, Claudio Alberto Dávila-Cervantes, Sharath Burugina Nagaraja, Getachew Mullu Kassa, Mohan Bairwa, Gurudatta Naik, André Karch, Gudlavalleti V S Murthy, Avula Laxmaiah, Farid Najafi, Birhanu Geta Meharie, Lorenzo Monasta, Amit Arora, Christopher S Yilgwan, Samer Hamidi, Keivan Ahmadi, Kebede Deribe, Ehimario U. Igumbor, Engida Yisma, Henok Biresaw Netsere, Mihajlo Jakovljevic, Ali S. Shalash, Thirunavukkarasu Sathish, Sachin R Atre, Mohamed I Hegazy, Mehedi Hasan, Hamidreza Haririan, Lucas Guimarães Abreu, Nejimu Biza Zepro, Surendra Karki, Krittika Bhattacharyya, Hiroshi Yatsuya, Gbenga A. Kayode, Osayomwanbo Osarenotor, Paul H. Lee, Deepak Paudel, Hagos Tasew Atalay, Hatem S Shehata, Mohammad Fareed, Adnan Kisa, Hisham Atan Edinur, Mehran Alijanzadeh, Shafiur Rahman, Mohammad Hossein Khosravi, Anusha Ganapati Bhat, Bahram Mohajer, Narinder Pal Singh, Shai Linn, Savita Lasrado, Joseph Adel Mattar Banoub, Amir Almasi-Hashiani, Mohd Anisul Karim, Praveen Hoogar, Kerrie E. Doyle, Bedilu Girma Weji, Juan Sanabria, Olatunji O. Adetokunboh, Mohamed Hsairi, Alireza Esteghamati, Seok Jun Yoon, Paramjit Gill, Dabere Nigatu, Tariq Jamal Siddiqi, Muhammad Usman, Rafael Alves Guimarães, Zemenu Tadesse Tessema, Aziz Sheikh, Florian Fischer, Peter Memiah, Rakesh Lodha, Nihal Thomas, Karzan Abdulmuhsin Mohammad, Mohammad Sadegh Rezai, Tanuj Kanchan, Vinay Nangia, Ashraf Nabhan, Gebre Teklemariam Demoz, Eirini Skiadaresi, Aleksandra Barac, Simon I. Hay, Sadaf G. Sepanlou, Michellr L. Bell, Nicola Luigi Bragazzi, Aklilu Endalamaw, Vishnu Renjith, Chinwe Juliana Iwu, Gabrielle B. Britton, Colm McAlinden, Ayenew Negesse Abejie, Smita Pakhale, Doris V.V. Ortega-Altamirano, Noushin Mohammadifard, Deborah Carvalho Malta, Vo Dinh Bay, Kirsten E. Wiens, Hamidreza Karimi-Sari, Mustafa Z. Younis, Shaimaa I. El-Jaafary, Morenike Oluwatoyin Folayan, Phetole Walter Mahasha, Mu'awiyyah Babale Sufiyan, Harish Chander Gugnani, Mohammad Hifz Ur Rahman, Sheikh Mohammed Shariful Islam, Maarten J. Postma, Usman Iqbal, Abdu A. Adamu, Marwa R.Rashad Salem I, Fares Alahdab, Vafa Rahimi-Movaghar, Zulfiqar A. Bhutta, Masoud Foroutan, Muhammad Shahzeb Khan, In-Hwan Oh, Yahya Salimi, Takeshi Fukumoto, Chhabi Lal Ranabhat, Tiffany K. Gill, Angel Paternina-Caicedo, Walter Mendoza, Sojib Bin Zaman, Olayinka Stephen Ilesanmi, Brigette F. Blacker, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Ambrish Singh, Mehdi Fazlzadeh, Mahesh P A, Carlo La Vecchia, Alex Yeshaneh, Benjamin K. Mayala, Aniruddha Deshpande, Agus Sudaryanto, Neeraj Bedi, Morteza Shamsizadeh, Jemal Abdu Mohammed, Vahid Alipour, Haileab Fekadu Wolde, Boris Bikbov, Ahmed Abualhasan, Ali H. Mokdad, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Jacek Jerzy Jozwiak, Alessandra C. Goulart, Mahmoud Yousefifard, Masood Ali Shaikh, Roya Safari-Faramani, MohammadBagher Shamsi, Aso Mohammad Darwesh, Amir Anoushiravani, Kebede Embaye Gezae, Degena Bahrey Tadesse, Paula Moraga, Maha El Tantawi, Rosario Cárdenas, Assefa Desalew, Vivek Kumar, Mina Anjomshoa, Junaid Khan, Jagdish Khubchandani, Marcel Ausloos, Soraya Siabani, Anwar E. Ahmed, Mohammed Ibrahim Mohialdeen Gubari, Andre M. N. Renzaho, Vuong Minh Nong, Kaushik Sarkar, Bruno Piassi Sao Jose, Yafeng Wang, Mitchell T. Wallin, Edgar Denova-Gutiérrez, Mohammad Hasan Imani-Nasab, Melese Abate Reta, Kala M. Mehta, Yahya Safari, Marufa Sultana, David C. Schwebel, Roghayeh Mohammadibakhsh, Samath D Dharmaratne, Maysaa El Sayed Zaki, Shiwei Liu, Gail Davey, Milena Ilic, Yunquan Zhang, Bahram Armoon, Seyed-Mohammad Fereshtehnejad, Jost B. Jonas, Dian Kusuma, Yawukal chane Kasahun, Beatriz Paulina Ayala Quintanilla, Mohammad Moradi-Joo, Gebrehiwot G. Kassa, Maria Jesus Rios-Blancas, Serge Resnikoff, Seifadin Ahmed Shallo, Bartosz Miazgowski, Huda Basaleem, Jobert Richie Nansseu, Enrico Rubagotti, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, Meysam Behzadifar, Maryam Adabi, Saravanan Muthupandian, Soumyadeep Bhaumik, hawariat, Carlos A Castañeda-Orjuela, Bhaskaran Unnikrishnan, Martin Amogre Ayanore, Dragos Virgil Davitoiu, Hossein Poustchi, Moses K. Muriithi, Dharmesh Kumar Lal, Ayman Grada, Rafael Tabarés-Seisdedos, Seyyed Shamsadin Athari, Ashish Pathak, Salvatore Rubino, Kenji Shibuya, Ana Laura Manda, Muluken Bekele Sorrie, Vivekanand Jha, Habtamu Kebebe Kasaye, Mohammad Hoseini, Sonali Kochhar, Van C. Lansingh, Ali Almasi, Amir Radfar, Till Bärnighausen, Marcia R. Weaver, Mowafa Househ, Arya Haj-Mirzaian, Gebremicheal Gebreslassie Kasahun, Arash Etemadi, Getahun Fentaw Mulaw, Zubair Kabir, Cuong Tat Nguyen, Chabila C Mapoma, Aubrey J. Levine, Solomon Gedlu Nigatu, Aslam Pervaiz, Muhammed Magdy Abd El Razek, Nataliya A. Foigt, Andrey Nikolaevich Briko, Sadaf Esteghamati, Chuanhua Yu, Pascual R. Valdez, Jennifer Rickard, Jennifer M. Ross, Ionut Negoi, Hailay Abrha Gesesew, Kamarul Imran Musa, Farshad Pourmalek, Kiomars Sharafi, Sangram Kishor Patel, Vera Marisa Costa, Mostafa Hosseini, Hajer Elkout, Mika Shigematsu, Bryan L. Sykes, Afarin Rahimi-Movaghar, Nuworza Kugbey, Vijay Kumar Chattu, Payman Salamati, Mona M. Khater, Reta Tsegaye Gayesa, Ehsan Sadeghi, Andrew T Olagunju, Govinda Prasad Dhungana, Dina Nur Anggraini Ningrum, Yaschilal Muche Belayneh, Leonardo Roever, Luca Ronfani, Nathaniel J. Henry, Brijesh Sathian, Hamid Sharifi, Liliana Preotescu, Joshua Longbottom, Somayeh Bohlouli, Huong Lan Thi Nguyen, Khaled Khatab, Ziyad Al-Aly, Ghobad Moradi, Ruth W Kimokoti, Jalal Arabloo, Mariam Molokhia, Maciej Banach, Hasan Yusefzadeh, Rahman Shiri, Girmay Teklay Weldesamuel, Mekdes Tigistu Yilma, Taweewat Wiangkham, Soewarta Kosen, Kovin Naidoo, Fernando de la Hoz, Mohammed Shannawaz, Berhe Etsay Tesfay I, Yogesh Sabde, Syed Mohamed Aljunid, Belay Tessema, Reza Malekzadeh, Tinuke O Olagunju, Olatunde Aremu, Mohammad Reza Salahshoor, Derrick A Bennett, Oladimeji M. Adebayo, Teshome Gebre, Narayan Bahadur Mahotra, Nelson J. Alvis-Zakzuk, Lauren E. Schaeffer, Alexandre C. Pereira, Mehdi Naderi, Mehdi Hosseinzadeh, Mehran Shams-Beyranvand, Ilais Moreno Velásquez, Rovshan Khalilov, Ai Koyanagi, Salman Khazaei, Ismael R. Campos-Nonato, Alaa Badawi, Amir Hasanzadeh, Gebreamlak Gebremedhn Gebremeskel, Gessessew Bugssa Hailu, Dessalegn Ajema Berbada, Kate E. LeGrand, Azadeh Shafieesabet, Nikolay Ivanovich Briko, Robert S. Bernstein, Irfan Ullah, Isaac Oluwafemi Dipeolu, Hadi Hassankhani, Keyghobad Ghadiri, Local Burden of Disease Diarrhoea Collaborator, Violante FS, Wiens, KE, Lindstedt, PA, Blacker, BF, Johnson, KB, Yisma, E, Ahmed, Muktar Beshir, Reiner, Robert C, Duko, Bereket, Local Burden of Disease Diarrhoea Collaborators, Microbes in Health and Disease (MHD), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Local Burden Dis Diarrhoea, Department of Earth Observation Science, UT-I-ITC-ACQUAL, Faculty of Geo-Information Science and Earth Observation, GeoHealth, HUS Comprehensive Cancer Center, Clinicum, Institute for Molecular Medicine Finland, Department of Oncology, University of Helsinki, and Instituto de Saúde Pública da Universidade do Porto

Subjects
RJ101, medicine.medical_treatment, CHILDREN, ZINC, 0302 clinical medicine, 030212 general & internal medicine, media_common, Geography, lcsh:Public aspects of medicine, 1. No poverty, Low income and middle income countries, General Medicine, 3142 Public health care science, environmental and occupational health, 3. Good health, Child, Preschool, A990 Medicine and Dentistry not elsewhere classified, Geographical inequalities, 0605 Microbiology, Diarrhea, AFRICA, Inequality, DEATHS, media_common.quotation_subject, 030231 tropical medicine, Developing country, Article, RS, 1117 Public Health and Health Services, 03 medical and health sciences, MORBIDITY, Environmental health, DIARRHEAL DISEASE, medicine, Humans, Oral rehydration therapy, Healthcare Disparities, Developing Countries, Models, Statistical, CHOLERA, MORTALITY, Infant, Newborn, Infant, lcsh:RA1-1270, Bayes Theorem, Middle income, GLOBAL BURDEN, Child mortality, 0605 Microbiology, 1117 Public Health and Health Services, Health Care Surveys, ITC-ISI-JOURNAL-ARTICLE, Fluid Therapy, NA, Human medicine, ITC-GOLD
Abstract

Background: Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs. Methods: We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received ORS or RHF (or both) on continuous continent-wide surfaces in 2000-17, and aggregated results to policy-relevant administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and creating uncertainty intervals (UIs) with the 2·5th and 97·5th percentiles of those 250 draws. Findings: While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage remained below 50% in the majority (62·6%; 12 417 of 19 823) of second administrative-level units and an estimated 6 519 000 children (95% UI 5 254 000-7 733 000) with diarrhoea were not treated with any form of ORT in 2017. Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall ORT coverage from 2000 to 2017. Although ORS was uniformly distributed subnationally in some countries, within-country geographical inequalities persisted in others; 11 countries had at least a 50% difference in one of their units compared with the country mean. Increases in ORS use over time were correlated with declines in RHF use and in diarrhoeal mortality in many locations, and an estimated 52 230 diarrhoeal deaths (36 910-68 860) were averted by scaling up of ORS coverage between 2000 and 2017. Finally, we identified key subnational areas in Colombia, Nigeria, and Sudan as examples of where diarrhoeal mortality remains higher than average, while ORS coverage remains lower than average. Interpretation: To our knowledge, this study is the first to produce and map subnational estimates of ORS, RHF, and ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, allowing for tracking progress over time. Our novel results, combined with detailed subnational estimates of diarrhoeal morbidity and mortality, can support subnational needs assessments aimed at furthering policy makers' understanding of within-country disparities. Over 50 years after the discovery that led to this simple, cheap, and life-saving therapy, large gains in reducing mortality could still be made by reducing geographical inequalities in ORS coverage. This work was primarily supported by a grant from the Bill & Melinda Gates Foundation (OPP1132415). L G Abreu has received support from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Finance Code 001), Conselho Nacional de Desenvolvimento Científico e Tecnológico and Fundação de Amparo à Pesquisa do Estado de Minas Gerais. O O Adetokunboh acknowledges the South African Department of Science and Innovation and the National Research Foundation. S M Aljunid acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University and International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. H T Atalay acknowledges Aksum University. M Ausloos and C Herteliu are partially supported by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. P S Azzopardi was supported by an Australian National Health and Medical Research Council (NHMRC) early career fellowship. A Badawi is supported by the Public Health Agency of Canada. T W Bärnighausen was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research; the EU; the Wellcome Trust; and from National Institute of Child Health and Human Development of National Institutes of Health (NIH; R01-HD084233), National Institute on Aging of NIH (P01-AG041710), National Institute of Allergy and Infectious Diseases of NIH (R01-AI124389 and R01-AI112339), as well as Fogarty International Center of NIH (D43-TW009775). G B Britton is supported by Sistema Nacional de Investigación (SNI) de la Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT) of Panamá. A Barac is funded by the Project of Ministry of Education, Science and Technology of the Republic of Serbia (number III45005). D A Bennett was supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR, or the UK Department of Health and Social Care. V M Costa acknowledges her grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006. F Carvalho acknowledges UID/MULTI/04378/2019 and UID/QUI/50006/2019 support with funding from FCT/Ministério da Ciência, Tecnologia e Ensino Superior through national funds. K Deribe is supported by a Wellcome Trust grant (number 201900/Z/16/Z) as part of his International Intermediate Fellowship. C Herteliu is partially supported by a grant co-funded by European Fund for Regional Development through the Operational Program for Competitiveness (project ID P_40_382). P Hoogar thanks Centre for Bio Cultural Studies, Directorate of Research, Manipal Academy of Higher Education, Manipal and Centre for Holistic Development and Research, Kalaghatgi-Karnataka. S M S Islam is funded by a Fellowship from National Heart Foundation of Australia and Deakin University. M Jakovljevic and the Serbian part of this GBD contribution was co-funded through grant OI175014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. A P Kengne is supported by the South African Medical Research Council. Y J Kim's work was supported by the Research Management Centre, Xiamen University Malaysia, grants number XMUMRF/2018-C2/ITCM/0001. K Krishan is supported by a DST PURSE grant and UGC Center of Advanced Study awarded to the Department of Anthropology, Panjab University, Chandigarh, India. M Kumar acknowledges K43 TW010716-03. B Lacey acknowledges support from the NIHR Oxford Biomedical Research Centre and the British Heart Foundation Centre of Research Excellence, Oxford. P T N Memiah acknowledges the Council for the Development of Social Science Research in Africa. M Molokhia is supported by the NIHR Biomedical Research Center at Guy's and St Thomas' National Health Service Foundation Trust and King's College London. I Moreno Velásquez is supported by the Sistema Nacional de Investigación (SENACYT, Panamá). G C Patton is funded by an NHMRC Fellowship. A M Samy received a fellowship from the Egyptian Fulbright Mission programme. M M Santric-Milicevic acknowledges the support of the Ministry of Education, Science and Technological Development of the Republic of Serbia (contract number 175087). A Sheikh acknowledges the support of Health Data Research UK. M R Sobhiyeh acknowledges the Clinical Research Development Center of Imam Reza Hospital, Kermanshah University of Medical Sciences for their wise advice. R Tabarés-Seisdedos was supported in part by grant PI17/00719 from Instituto de Salud Carlos III–FEDER. B Unnikrishnan acknowledges Manipal Academy of Higher Education, Manipal. M R Weaver was supported by the Bill & Melinda Gates Foundation grant OPP1127433. C S Wiysonge was supported by the South African Medical Research Council.

Published
2020

8. Quantifying risks and interventions that have affected the burden of diarrhoea among children younger than 5 years : an analysis of the Global Burden of Disease Study 2017

Author

Gessessew Bugssa Hailu, Arvin Haj-Mirzaian, Yuming Guo, Soewarta Kosen, Irfan Ullah, Khanh Bao Tran, Joan B. Soriano, Carl Abelardo T. Antonio, Teklay G E Teklu, Smita Pakhale, Dietrich Rothenbacher, Christopher Troeger, Eyasu Ejeta Duken, Erkin M. Mirrakhimov, Helena Manguerra, Cuong Tat Nguyen, Chalachew Genet Akal, Rakhi Dandona, Alaa Badawi, Barthelemy Kuate Defo, Sonali Kochhar, Javad Nazari, Evanson Z. Sambala, Nelson Alvis-Guzman, G Anil Kumar, Niranjan Kissoon, Yousef Veisani, Ai Koyanagi, Lalit Dandona, Molly R Nixon, David L. Smith, Samah Awad, Seyyed Meysam Mousavi, Rachel L Updike, Rajesh Kumar Rai, Hagos Tasew Atalay, Giuseppe Gorini, Charles Shey Wiysonge, Molly H Biehl, Zoubida Zaidi, Ahmad Daryani, Bach Xuan Tran, André Karch, Mostafa Qorbani, Zikria Saleem, Addisu Melese, Devasahayam J. Christopher, Adane Teshome Kefale, Félix Carvalho, Stephen S Lim, Birhanu Geta, Aziz Sheikh, Reginald Quansah, Andrew T Olagunju, Jalal Arabloo, Karzan Abdulmuhsin Mohammad, Fiseha Wadilo Wada, Amir Kasaeian, Maarten J. Postma, Abdullah T Khoja, Ravi Prakash Jha, Syed Mohamed Aljunid, Yousef Khader, Heather J. Zar, Ali Bijani, Ibrahim A Khalil, William M. Gardner, Marcia R. Weaver, Ebrahim M Yimer, Srinivas Murthy, Quique Bassat, Mu'awiyyah Babale Sufiyan, Kirsten E. Wiens, Saeed Amini, Ziad A. Memish, Samer Hamidi, Shanshan Li, Belay Tessema, Erlyn Rachelle King Macarayan, Tinuke O Olagunju, Alessandra C. Goulart, Seyed Sina Naghibi Irvani, Mahesh P A, Olatunde Aremu, Spencer L. James, Derrick A Bennett, Sezer Kisa, Keyghobad Ghadiri, Alireza Ahmadi, Theo Vos, Tuomo J. Meretoja, Mika Shigematsu, Naohiro Yonemoto, Shirin Djalalinia, Rakesh Lodha, Anselm Okoro, Adnan Kisa, Ali H. Mokdad, Aman Yesuf Endries, Josip Car, Fakher Rahim, Cheru Tesema Leshargie, Babak Moazen, Hamid Yimam Hassen, Lorenzo Monasta, Abdullah Al Mamun, Young-Ho Khang, Yasir Waheed, Mohamad-Hani Temsah, Zakir Hussain, Milena M Santric Milicevic, Abdallah M. Samy, Ejaz Ahmad Khan, Hmwe H Kyu, Afshin Zarghi, Monika Sawhney, Ghulam Mustafa, Samuel B. Albertson, Tomislav Mestrovic, Long Hoang Nguyen, Marek Majdan, Maysaa El Sayed Zaki, Mihaela Hostiuc, Desalegn Tadese Mengistu, Chi Linh Hoang, Christopher J L Murray, Nahla Anber, Seyedmojtaba Seyedmousavi, Maria Jesus Rios-Blancas, Mohammad Sadegh Rezai, Ashish Awasthi, Robert Reiner, Carlos A Castañeda-Orjuela, Shafiu Mohammed, Saeed Safari, Catrin E. Moore, Mina Anjomshoa, Joseph Adel Mattar Banoub, Fares Alahdab, Vafa Rahimi-Movaghar, Aniruddha Deshpande, Nicholas J Kassebaum, Kefyalew Addis Alene, Rajaa Al-Raddadi, Nancy Fullman, Benn Sartorius, Nuruzzaman Khan, Manisha Dubey, Eleonora Dubljanin, Stephanie R M Zimsen, Jost B. Jonas, Dharmesh Kumar Lal, Feleke Mekonnen Demeke, Jeffrey D. Stanaway, Euripide Frinel G Arthur Avokpaho, Tommi Vasankari, Florian Fischer, Krittika Bhattacharyya, Aleksandra Barac, Simon I. Hay, Kalpana Balakrishnan, Brigette F. Blacker, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Puja C Rao, Neeraj Bedi, Masood Ali Shaikh, Bartosz Miazgowski, Arya Haj-Mirzaian, Mohamed Lemine Cheikh brahim Ahmed, Vahid Alipour, Tesfaye Dessale Kassa, Luca Ronfani, Suleman Atique, Muhammad Imran Nisar, Alireza Rafiei, Aziz Rezapour, Ruth W Kimokoti, Noore Alam, Zulfiqar A Bhutta, Katherine Rosettie, Jonathan F. Mosser, Felix Akpojene Ogbo, Degu Abate, Clinicum, HUS Comprehensive Cancer Center, Staff Services, University of Helsinki, Department of Oncology, Public Health, Microbes in Health and Disease (MHD), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Collaborators, GBD 2017 Diarrhoeal Disease, and GBD 2017 Diarrhoeal Dis

Subjects
Male, Diarrhea, AFRICA, 030231 tropical medicine, Developing country, Global Health, Risk Assessment, Global Burden of Disease, 03 medical and health sciences, MORBIDITY, Life Expectancy, 0302 clinical medicine, SDG 3 - Good Health and Well-being, SANITATION, NUTRITIONAL INTERVENTIONS, Environmental health, Prevalence, Global health, Humans, Medicine, 030212 general & internal medicine, Risk factor, Child, Developing Countries, Wasting, Children, Models, Statistical, business.industry, Mortality rate, MORTALITY, 1. No poverty, Infant, Verbal autopsy, 3. Good health, Infectious Diseases, Socioeconomic Factors, WATER-QUALITY, Child, Preschool, Relative risk, 3121 General medicine, internal medicine and other clinical medicine, Child Mortality, GROWTH, Female, Human medicine, medicine.symptom, business, Risk assessment, Diarrea, Infants
Abstract

Background Many countries have shown marked declines in diarrhoeal disease mortality among children younger than 5 years. With this analysis, we provide updated results on diarrhoeal disease mortality among children younger than 5 years from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) and use the study's comparative risk assessment to quantify trends and effects of risk factors, interventions, and broader sociodemographic development on mortality changes in 195 countries and territories from 1990 to 2017. Methods This analysis for GBD 2017 had three main components. Diarrhoea mortality was modelled using vital registration data, demographic surveillance data, and verbal autopsy data in a predictive, Bayesian, ensemble modelling tool; and the attribution of risk factors and interventions for diarrhoea were modelled in a counterfactual framework that combines modelled population-level prevalence of the exposure to each risk or intervention with the relative risk of diarrhoea given exposure to that factor. We assessed the relative and absolute change in diarrhoea mortality rate between 1990 and 2017, and used the change in risk factor exposure and sociodemographic status to explain differences in the trends of diarrhoea mortality among children younger than 5 years. Findings Diarrhoea was responsible for an estimated 533 768 deaths (95% uncertainty interval 477 162–593 145) among children younger than 5 years globally in 2017, a rate of 78·4 deaths (70·1–87·1) per 100 000 children. The diarrhoea mortality rate ranged between countries by over 685 deaths per 100 000 children. Diarrhoea mortality per 100 000 globally decreased by 69·6% (63·1–74·6) between 1990 and 2017. Among the risk factors considered in this study, those responsible for the largest declines in the diarrhoea mortality rate were reduction in exposure to unsafe sanitation (13·3% decrease, 11·2–15·5), childhood wasting (9·9% decrease, 9·6–10·2), and low use of oral rehydration solution (6·9% decrease, 4·8–8·4). Interpretation Diarrhoea mortality has declined substantially since 1990, although there are variations by country. Improvements in sociodemographic indicators might explain some of these trends, but changes in exposure to risk factors—particularly unsafe sanitation, childhood growth failure, and low use of oral rehydration solution—appear to be related to the relative and absolute rates of decline in diarrhoea mortality. Although the most effective interventions might vary by country or region, identifying and scaling up the interventions aimed at preventing and protecting against diarrhoea that have already reduced diarrhoea mortality could further avert many thousands of deaths due to this illness. Funding Bill & Melinda Gates Foundation.

Published
2020

9. Global Mortality From Firearms, 1990-2016

Author

Leticia Avila-Burgos, Mahdi Safdarian, Devina Nand, Tim Driscoll, David C. Schwebel, Andrew T Olagunju, Saeid Safiri, Vasily Vlassov, Dina Nur Anggraini Ningrum, Jost B. Jonas, Reyna A Gutiérrez, Delia Hendrie, Fentaw Tadese, Jagdish Khubchandani, Gessessew Bugssa Hailu, Bach Xuan Tran, Mekonnen Sisay, Amanda J. Mason-Jones, Mu'awiyyah Babale Sufiyan, Tommi Vasankari, Kyle J Foreman, Kristopher J. Krohn, Haftay Berhane Mezgebe, Christian Kieling, Nadia Akseer, Maheswar Satpathy, Reza Assadi, Christopher J L Murray, Tsegaye Tewelde Gebrehiwot, Ali Rowhani-Rahbar, Rakhi Dandona, Sudha Jayaraman, Rintaro Mori, Mustafa Z. Younis, Tesfay Mehari Atey, Ashish Awasthi, Amit Arora, Rodrigo Sarmiento-Suarez, Kingsley N. Ukwaja, Alan D. Lopez, Masoud Behzadifar, Ibrahim A Khalil, G Anil Kumar, George C Patton, Nancy Fullman, Nigussie Tadesse Sharew, André Faro, Guoqing Hu, Yousef Khader, Benn Sartorius, Suzanne Barker-Collo, Young-Ho Khang, Rajesh Sagar, Martha Híjar, Florian Fischer, Suliman Alghnam, Michael Kutz, Valery L. Feigin, Raimundas Lunevicius, Suzanne Polinder, Bryan L. Sykes, Van C. Lansingh, Adauto Martins Soares Filho, Mamta Swaroop, Jasvinder A. Singh, Mohsen Asadi-Lari, Afarin Rahimi-Movaghar, Spencer L. James, Alireza Esteghamati, Theo Vos, Tuomo J. Meretoja, Soewarta Kosen, Kerrie E. Doyle, Michael R. Phillips, Amaha Kahsay, Miloud Taki Eddine Aichour, Samath D Dharmaratne, James R. Bennett, Rohan Borschmann, Muhammed Magdy Abd El Razek, Rafael Tabarés-Seisdedos, Joseph S Salama, Salman Rawaf, Hamid Yimam Hassen, Heidi J. Larson, Ted R. Miller, Caitlin Hawley, Beatriz Paulina Ayala Quintanilla, Katya Anne Shackelford, Lalit Dandona, Vafa Rahimi-Movaghar, Aman Yesuf Endries, Guilherme Borges, Carlos A Castañeda-Orjuela, Shahrzad Bazargan-Hejazi, Soraya Seedat, Paul S. F. Yip, Juan Sanabria, Maziar Moradi-Lakeh, Farshad Pourmalek, Olayinka Stephen Ilesanmi, Masood Ali Shaikh, Mahfuzar Rahman, Richard Matzopoulos, Richard C. Franklin, Huyen Phuc Do, Mostafa Qorbani, Eric L. Ding, Mark A. Stokes, Rajaa Al-Raddadi, Stephen S Lim, Tung Thanh Tran, Dan J. Stein, Naohiro Yonemoto, Mohsen Naghavi, Vegard Skirbekk, Chhabi Lal Ranabhat, Walter Mendoza, Arebu Issa Bilal, Pengpeng Ye, Shai Linn, Ali H. Mokdad, Alexandra Brazinova, Nima Hafezi-Nejad, Julio Cesar Campuzano Rincon, Ashish Bhalla, Simon I. Hay, Deborah Carvalho Malta, David Teye Doku, Ivy Shiue, Farshad Farzadfar, Shafiu Mohammed, Aliasghar Ahmad Kiadaliri, Molly K. Miller-Petrie, Khurshid Alam, Milena M Santric Milicevic, Dumessa Edessa, Quyen Nguyen, Rajesh Kumar Rai, Paul I. Dargan, Reza Malekzadeh, Olatunde Aremu, David Laith Rawaf, Zoubida Zaidi, Hassan Magdy Abd El Razek, Carl Abelardo T. Antonio, Meysam Behzadifar, Josep Maria Haro, Ziad El-Khatib, Cuong Tat Nguyen, Laurie B. Marczak, Peter Njenga Keiyoro, Andrea Werdecker, Megha Arora, Neal D. Futran, Maysaa El Sayed Zaki, Diego De Leo, Faris Lami, Hassan Haghparast Bidgoli, Amir Kasaeian, Peter Memiah, Zulfiqar A Bhutta, Till Bärnighausen, Sadaf G. Sepanlou, Felix Akpojene Ogbo, Mihajlo Jakovljevic, Félix Carvalho, Yun Jin Kim, Global Burden Dis 2016 Injury Col, Universitat de Barcelona, and Public Health

Subjects
Male, Global Health, 01 natural sciences, 0302 clinical medicine, Firearm injury, Armas de Fuego, Homicide, Global health, Medicine, 030212 general & internal medicine, Young adult, Child, Aged, 80 and over, Mortality rate, Armes de foc, 11 Medical And Health Sciences, General Medicine, Middle Aged, 16. Peace & justice, Firearm suicide, Suicide, Gun ownership, Child, Preschool, Violencia, Female, Adult, Firearms, Adolescent, Uncertainty interval, Violence, Young Adult, 03 medical and health sciences, Age Distribution, General & Internal Medicine, Mortalitat, Humans, Vital registration, Suicidio, Sex Distribution, 0101 mathematics, Mortality, Aged, business.industry, 010102 general mathematics, Infant, Newborn, Infant, Heridas por Arma de Fuego, Homicidio, Mortalidad, Wounds, Gunshot, Human medicine, business, Demography
Abstract

IMPORTANCE: Understanding global variation in firearm mortality rates could guide prevention policies and interventions. OBJECTIVE: To estimate mortality due to firearm injury deaths from 1990 to 2016 in 195 countries and territories. DESIGN, SETTING, AND PARTICIPANTS: This study used deidentified aggregated data including 13 812 location-years of vital registration data to generate estimates of levels and rates of death by age-sex-year-location. The proportion of suicides in which a firearm was the lethal means was combined with an estimate of per capita gun ownership in a revised proxy measure used to evaluate the relationship between availability or access to firearms and firearm injury deaths. EXPOSURES: Firearm ownership and access. MAIN OUTCOMES AND MEASURES: Cause-specific deaths by age, sex, location, and year. RESULTS: Worldwide, it was estimated that 251 000 (95% uncertainty interval [UI], 195 000-276 000) people died from firearm injuries in 2016, with 6 countries (Brazil, United States, Mexico, Colombia, Venezuela, and Guatemala) accounting for 50.5% (95% UI, 42.2%-54.8%) of those deaths. In 1990, there were an estimated 209 000 (95% UI, 172 000 to 235 000) deaths from firearm injuries. Globally, the majority of firearm injury deaths in 2016 were homicides (64.0% [95% UI, 54.2%-68.0%]; absolute value, 161 000 deaths [95% UI, 107 000-182 000]); additionally, 27% were firearm suicide deaths (67 500 [95% UI, 55 400-84 100]) and 9% were unintentional firearm deaths (23 000 [95% UI, 18 200-24 800]). From 1990 to 2016, there was no significant decrease in the estimated global age-standardized firearm homicide rate (-0.2% [95% UI, -0.8% to 0.2%]). Firearm suicide rates decreased globally at an annualized rate of 1.6% (95% UI, 1.1-2.0), but in 124 of 195 countries and territories included in this study, these levels were either constant or significant increases were estimated. There was an annualized decrease of 0.9% (95% UI, 0.5%-1.3%) in the global rate of age-standardized firearm deaths from 1990 to 2016. Aggregate firearm injury deaths in 2016 were highest among persons aged 20 to 24 years (for men, an estimated 34 700 deaths [95% UI, 24 900-39 700] and for women, an estimated 3580 deaths [95% UI, 2810-4210]). Estimates of the number of firearms by country were associated with higher rates of firearm suicide (P

Published
2018

10. Global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2017, and forecasts to 2030, for 195 countries and territories: a systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017

Author

Ephrem Tsegay Asfaw, Irina Filip, Maciej Banach, Amjad Mohamadi-Bolbanabad, Girmay Teklay Weldesamuel, Joshua A. Salomon, Anemaw A Asrat, Zahra Jorjoran Shushtari, Hamidreza Komaki, Mekdes Tigistu Yilma, Reza Shirkoohi, Mostafa Qorbani, Ahamarshan Jayaraman Nagarajan, Don C. Des Jarlais, Adnan Kisa, Gebreamlak Gebremedhn Gebremeskel, Kidu Gidey Weldegwergs, Amir Kasaeian, Peter Memiah, Son Hoang Nguyen, Segun Emmanuel Ibitoye, Ali Kabir, Subash Thapa, Diego Augusto Santos Silva, Kefyalew Addis Alene, Alireza Rafiei, Huong Lan Thi Nguyen, Erlyn Rachelle King Macarayan, Kelali Kalaye Gebreyohannes, Khaled Khatab, Ghobad Moradi, Noore Alam, Aletta E. Schutte, Sharareh Eskandarieh, H. Dean Hosgood, Rakhi Dandona, Taye Abuhay Zewale, Sezer Kisa, Gessessew Bugssa Hailu, Hedayat Abbastabar, Ketema Bizuwork Gebremedhin, Smita Pakhale, Govinda Prasad Dhungana, Dina Nur Anggraini Ningrum, Bakhtiar Piroozi, Yaschilal Muche Belayneh, Tesfaye Dessale Kassa, Irfan Ullah, Sahar Saeedi Moghaddam, Jean Jacques Noubiap, Mojtaba Bagherzadeh, Akram Pourshams, Alberto L. García-Basteiro, Helen Bitew, Kindie Fentahun Muchie, Mehdi Sayyah, Kevin S Ikuta, Moses K. Muriithi, Aliasghar Ahmad Kiadaliri, Zerihun Menlkalew Zenebe, Cesar Reis, Themba G. Ginindza, Jagadish Rao Padubidri, Yoosik Youm, Saba Abraham Belay, Olayinka Stephen Ilesanmi, Neeraj Bedi, Maziar Moradi-Lakeh, Hamid Sharifi, Nefsu Awoke, Manasi Kumar, Carlos Magis-Rodriguez, Muhammad Shahdaat Bin Sayeed, Maheswar Satpathy, Andrew Blinov, Fiseha Wadilo Wada, Babak Moazen, Hadi Hassankhani, Jae Il Shin, Sanjay Basu, Aziz Eftekhari, Masood Ali Shaikh, Arya Haj-Mirzaian, Laura Dwyer-Lindgren, Haileab Fekadu Wolde, Habtamu Abera Areri, Krista M. Steuben, Lalit Dandona, Keivan Ahmadi, Aso Mohammad Darwesh, Belete Kassa, Keyghobad Ghadiri, Arash Ziapour, Raquel Crider, Alaa Badawi, Tahvi Frank, Amir Hasanzadeh, Marcel Yotebieng, Jemal Abdu Mohammed, Marcos Roberto Tovani-Palone, Emmanuel Peprah, Mekonnen Sisay, Ghulam Mustafa, Oghenowede Eyawo, Seyed Sina Naghibi Irvani, Vahid Alipour, Reza Malekzadeh, Bereket Duko Adema, Direslgne Misker Abyu, Tinuke O Olagunju, Olatunde Aremu, Roghayeh Mohammadibakhsh, Linh Phuong Doan, Mihiretu Kebede, Aman Yesuf Endries, Amira Shaheen, Belete Biadgo, Ali Rostami, Marwa Rashad Salem, Getnet Gedefaw, Stein Emil Vollset, Gurudatta Naik, Veincent Christian Filipino Pepito, Duduzile Ndwandwe, Melese Abate Reta, Aleksandra Barac, Simon I. Hay, Vishnu Renjith, Seifadin Ahmed Shallo, Kebede Deribe, Malihe Nourollahpour Shiadeh, Tewodros Eshete Wonde, Nuno Taveira, Mohammad Ali Sahraian, Marilita M Moschos, Masoud Foroutan, Alebachew Fasil Ashagre, Félix Carvalho, Yun Jin Kim, Farid Najafi, Tukur Dahiru, Chinwe Juliana Iwu, Dharmesh Kumar Lal, Varshil Mehta, Molly R Nixon, Nahla Anber, Seyedmojtaba Seyedmousavi, Mohammad Rabiee, Nauman Khalid, Felix Akpojene Ogbo, Anselm Okoro, Sanjay Zodpey, Birhanu Geta, Kebede Embaye Gezae, Shirin Djalalinia, Amanda E. Smith, Naser Mohammad Gholi Mezerji, Arvin Haj-Mirzaian, Birkneh Tilahun Tadesse, Yared Belete Belay, Saeed Amini, Ziad A. Memish, Stephanie M. Topp, Eduarda Fernandes, Mohammed Suleiman Obsa, Junaid Khan, Andem Effiong, Jane Jean-Hee Lee, Emmanuel Ngassa Laurent Mayenga, Abdallah M. Samy, Anton Sokhan, Rajesh Sagar, Dawit Zewdu Wondafrash, Atalay Goshu Muluneh, Birhan Alemnew, Asmamaw Demis, Samer Hamidi, Getnet Mengistu, Michael Tamene Haile, Gbenga A. Kayode, Huyen Phuc Do, Yoshan Moodley, Mehdi Hosseinzadeh, Moslem Mohammadi, Dayane Gabriele Alves Silveira, Samad Azari, Gulfaraz Khan, Maysaa El Sayed Zaki, Emmanuel Ankrah Odame, Anusha Ganapati Bhat, Louisa Degenhardt, Mu'awiyyah Babale Sufiyan, Harish Chander Gugnani, Sadaf G. Sepanlou, Ai Koyanagi, Ebrahim M Yimer, Maryam Adabi, Javad Nazari, Saravanan Muthupandian, Evanson Z. Sambala, Salman Khazaei, Nelson Alvis-Guzman, Hunduma Amensisa Bojia, Anwar Rafay, Richard Ofori-Asenso, Ehsan Ahmadpour, José Neves, Desalegn Tadese Mengistu, Shafiu Mohammed, Hamid Yimam Hassen, Navid Rabiee, Dinh-Toi Chu, Zoubida Zaidi, Sajjad Ur Rahman, Tilahun Belete Mossie, Olanrewaju Oladimeji, Krittika Bhattacharyya, Gebrekiros Gebremichael Meles, Hassan Magdy Abd El Razek, Stanislav S. Otstavnov, Shaimaa I. El-Jaafary, Habtamu Temesgen, Lolemo Kelbiso Hanfore, Milad Mohammadoo-Khorasani, Muktar Beshir Ahmed, Karzan Abdulmuhsin Mohammad, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, Spencer L. James, Bhaskaran Unnikrishnan, Morteza Shamsizadeh, Kenean Getaneh Tlaye, Ziad El-Khatib, Zohreh Anbari, Aisha Elsharkawy, Nancy Fullman, Cuong Tat Nguyen, Chalachew Genet Akal, Chabila C Mapoma, Amir H. Pakpour, Rafael Alves Guimarães, Jalal Arabloo, Eyasu Ejeta Duken, Hailay Abrha Gesesew, Koku Sisay Tamirat, Batool Fatima, Tissa Wijeratne, Addisu Gize Yeshanew, Benn Sartorius, Kathryn H. Jacobsen, Abdullah T Khoja, Morenike Oluwatoyin Folayan, Phetole Walter Mahasha, Takeshi Fukumoto, Maryam Moossavi, Bahram Mohajer, Ravi Prakash Jha, Oladimeji Adebayo, Farshad Farzadfar, Francisco Rogerlândio Martins-Melo, Solomon Sisay, Ensiyeh Jenabi, Bach Xuan Tran, Eleonora Dubljanin, Farnam Mohebi, Jasvinder A. Singh, Barthelemy Kuate Defo, Masoud Behzadifar, Yousef Mohammad, Feleke Mekonnen Demeke, G Anil Kumar, Jan-Walter De Neve, Afshin Zarghi, Hosein Shabaninejad, Trang Huyen Nguyen, Degena Bahrey Tadesse, Monika Sawhney, Eyal Oren, Bayu Begashaw Bekele, Saeed Safari, Salvatore Rubino, Kenji Shibuya, Daniel Diaz, Salman Rawaf, Demelash Woldeyohannes Handiso, Ted R. Miller, Fares Alahdab, Vafa Rahimi-Movaghar, Seyyed Meysam Mousavi, Sonali Kochhar, Azeem Majeed, Till Bärnighausen, Zubair Kabir, Devasahayam J. Christopher, Malede Mequanent Sisay, Adane Teshome Kefale, Shishay Wahdey Tekelemedhin, Tsegaye Lolaso Lenjebo, Yousef Khader, Ali Bijani, Kebreab Paulos, Hagazi Gebre Meles, Euripide Frinel G Arthur Avokpaho, Alireza Ahmadi, Tuomo J. Meretoja, Padukudru Anand Mahesh, Florian Fischer, Mulugeta Melku, Fakher Rahim, Manisha Dubey, Cheru Tesema Leshargie, Vijay Kumar Chattu, Yasir Waheed, Mehdi Noroozi, Austin Carter, Chuanhua Yu, Ronny Westerman, Andualem Henok, Yousef Veisani, Sharath Burugina Nagaraja, Reta Tsegaye Gayesa, Mina Anjomshoa, Andrew T Olagunju, Getachew Mullu Kassa, Belayneh K Gelaw, Jost B. Jonas, Ejaz Ahmad Khan, Adugnaw Berhane, Chukwudi A Nnaji, Daniel Asmelash, Tomislav Mestrovic, Addisu Melese, Stephen S Lim, Yahya Salimi, Chi Linh Hoang, Christopher J L Murray, Mohammad Sadegh Rezai, Bruno F. Sunguya, Herbert C. Duber, Senad Handanagic, Ashish Awasthi, Anthony Masaka, Megha Arora, Sergey Soshnikov, Sangram Kishor Patel, Kwaku Oppong Asante, Haidong Wang, Rajendra Kadel, Bryan L. Sykes, Lucero Cahuana-Hurtado, Afarin Rahimi-Movaghar, Deepa Jahagirdar, Manaye Yihune Teshale, Samantha Leigh Larson, Martin Amogre Ayanore, Sergey K Vladimirov, Gebre Teklemariam Demoz, Fisaha Haile Tesfay, Mohsen Naghavi, Chhabi Lal Ranabhat, Walter Mendoza, Kassawmar Angaw Bogale, Khanh Bao Tran, Berhanu Yazew Wondmagegn, Carlos Miguel Rios González, Ahmad Daryani, Ali H. Mokdad, Julio Cesar Campuzano Rincon, Alemayehu Toma Mena, Navid Manafi, Andre Pascal Kengne, Victor Adekanmbi, Netsanet Fentahun, Olalekan A. Uthman, Desmond Kuupiel, Olatunji O. Adetokunboh, Zahid A Butt, Mohamed Hsairi, Bulat Idrisov, Ranjani Somayaji, Dan J. Stein, Molly H Biehl, Samuel B. Albertson, Laith J. Abu-Raddad, Parvaiz A Koul, Elias Merdassa Roro, Marek Majdan, Dereje Bayissa Demissie, Emilie R Maddison, Naohiro Yonemoto, Ahmad Ghashghaee, Young-Ho Khang, Solomon Olum, Hmwe H Kyu, Amir Radfar, Dirk Douwes-Schultz, Elham Ahmadian, Graduate School, AII - Infectious diseases, APH - Global Health, APH - Methodology, GBD 2017 HIV Collaborators, Clinicum, Institute for Molecular Medicine Finland, HUS Comprehensive Cancer Center, Staff Services, University of Helsinki, Department of Oncology, Adema, Bereket Duko, GBD 2017 HIV collaborators, and Public Health

Subjects
0301 basic medicine, A300 Clinical Medicine, Epidemiology, CITIES, HIV Infections, Mortalities, Global Burden of Disease, 0302 clinical medicine, Risk Factors, Seroepidemiologic Studies, Cause of Death, Prevalences, Prevalence, Global health, LIFE EXPECTANCY, 030212 general & internal medicine, 10. No inequality, education.field_of_study, CHALLENGES, Incidence, Incidence (epidemiology), Incidences, 1. No poverty, MEN, 3. Good health, AIDS, Infectious Diseases, Life Sciences & Biomedicine, GBD 2017 HIV collaborators, medicine.medical_specialty, Forecasts, Immunology, Population, Cause of Death/trends, UNITED-STATES, Context (language use), History, 21st Century, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Acquired immunodeficiency syndrome (AIDS), Virology, Environmental health, medicine, Humans, education, Global Burden of Disease/trends, Estimation, Science & Technology, SEX-SPECIFIC MORTALITY, business.industry, DISABILITY, Public health, HIV, coverage of antiretroviral therapy, History, 20th Century, medicine.disease, mortality, R1, PREVENTION, TRENDS, 030112 virology, HIV Infections/mortality, 3121 General medicine, internal medicine and other clinical medicine, Life expectancy, Human medicine, business, Forecasting
Abstract

BACKGROUND: Understanding the patterns of HIV/AIDS epidemics is crucial to tracking and monitoring the progress of prevention and control efforts in countries. We provide a comprehensive assessment of the levels and trends of HIV/AIDS incidence, prevalence, mortality, and coverage of antiretroviral therapy (ART) for 1980-2017 and forecast these estimates to 2030 for 195 countries and territories.METHODS: We determined a modelling strategy for each country on the basis of the availability and quality of data. For countries and territories with data from population-based seroprevalence surveys or antenatal care clinics, we estimated prevalence and incidence using an open-source version of the Estimation and Projection Package-a natural history model originally developed by the UNAIDS Reference Group on Estimates, Modelling, and Projections. For countries with cause-specific vital registration data, we corrected data for garbage coding (ie, deaths coded to an intermediate, immediate, or poorly defined cause) and HIV misclassification. We developed a process of cohort incidence bias adjustment to use information on survival and deaths recorded in vital registration to back-calculate HIV incidence. For countries without any representative data on HIV, we produced incidence estimates by pulling information from observed bias in the geographical region. We used a re-coded version of the Spectrum model (a cohort component model that uses rates of disease progression and HIV mortality on and off ART) to produce age-sex-specific incidence, prevalence, and mortality, and treatment coverage results for all countries, and forecast these measures to 2030 using Spectrum with inputs that were extended on the basis of past trends in treatment scale-up and new infections.FINDINGS: Global HIV mortality peaked in 2006 with 1·95 million deaths (95% uncertainty interval 1·87-2·04) and has since decreased to 0·95 million deaths (0·91-1·01) in 2017. New cases of HIV globally peaked in 1999 (3·16 million, 2·79-3·67) and since then have gradually decreased to 1·94 million (1·63-2·29) in 2017. These trends, along with ART scale-up, have globally resulted in increased prevalence, with 36·8 million (34·8-39·2) people living with HIV in 2017. Prevalence of HIV was highest in southern sub-Saharan Africa in 2017, and countries in the region had ART coverage ranging from 65·7% in Lesotho to 85·7% in eSwatini. Our forecasts showed that 54 countries will meet the UNAIDS target of 81% ART coverage by 2020 and 12 countries are on track to meet 90% ART coverage by 2030. Forecasted results estimate that few countries will meet the UNAIDS 2020 and 2030 mortality and incidence targets.INTERPRETATION: Despite progress in reducing HIV-related mortality over the past decade, slow decreases in incidence, combined with the current context of stagnated funding for related interventions, mean that many countries are not on track to reach the 2020 and 2030 global targets for reduction in incidence and mortality. With a growing population of people living with HIV, it will continue to be a major threat to public health for years to come. The pace of progress needs to be hastened by continuing to expand access to ART and increasing investments in proven HIV prevention initiatives that can be scaled up to have population-level impact.FUNDING: Bill & Melinda Gates Foundation, National Institute of Mental Health of the US National Institutes of Health (NIH), and the National Institute on Aging of the NIH.

Published
2019

11. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017

Author

Gregory A Roth, Degu Abate, Kalkidan Hassen Abate, Solomon M Abay, Cristiana Abbafati, Nooshin Abbasi, Hedayat Abbastabar, Foad Abd-Allah, Jemal Abdela, Ahmed Abdelalim, Ibrahim Abdollahpour, Rizwan Suliankatchi Abdulkader, Haftom Temesgen Abebe, Molla Abebe, Zegeye Abebe, Ayenew Negesse Abejie, Semaw F Abera, Olifan Zewdie Abil, Haftom Niguse Abraha, Aklilu Roba Abrham, Laith Jamal Abu-Raddad, Manfred Mario Kokou Accrombessi, Dilaram Acharya, Abdu A Adamu, Oladimeji M Adebayo, Rufus Adesoji Adedoyin, Victor Adekanmbi, Olatunji O Adetokunboh, Beyene Meressa Adhena, Mina G Adib, Amha Admasie, Ashkan Afshin, Gina Agarwal, Kareha M Agesa, Anurag Agrawal, Sutapa Agrawal, Alireza Ahmadi, Mehdi Ahmadi, Muktar Beshir Ahmed, Sayem Ahmed, Amani Nidhal Aichour, Ibtihel Aichour, Miloud Taki Eddine Aichour, Mohammad Esmaeil Akbari, Rufus Olusola Akinyemi, Nadia Akseer, Ziyad Al-Aly, Ayman Al-Eyadhy, Rajaa M Al-Raddadi, Fares Alahdab, Khurshid Alam, Tahiya Alam, Animut Alebel, Kefyalew Addis Alene, Mehran Alijanzadeh, Reza Alizadeh-Navaei, Syed Mohamed Aljunid, Ala'a Alkerwi, François Alla, Peter Allebeck, Jordi Alonso, Khalid Altirkawi, Nelson Alvis-Guzman, Azmeraw T Amare, Leopold N Aminde, Erfan Amini, Walid Ammar, Yaw Ampem Amoako, Nahla Hamed Anber, Catalina Liliana Andrei, Sofia Androudi, Megbaru Debalkie Animut, Mina Anjomshoa, Hossein Ansari, Mustafa Geleto Ansha, Carl Abelardo T Antonio, Palwasha Anwari, Olatunde Aremu, Johan Ärnlöv, Amit Arora, Monika Arora, Al Artaman, Krishna K Aryal, Hamid Asayesh, Ephrem Tsegay Asfaw, Zerihun Ataro, Suleman Atique, Sachin R Atre, Marcel Ausloos, Euripide F G A Avokpaho, Ashish Awasthi, Beatriz Paulina Ayala Quintanilla, Yohanes Ayele, Rakesh Ayer, Peter S Azzopardi, Arefeh Babazadeh, Umar Bacha, Hamid Badali, Alaa Badawi, Ayele Geleto Bali, Katherine E Ballesteros, Maciej Banach, Kajori Banerjee, Marlena S Bannick, Joseph Adel Mattar Banoub, Miguel A Barboza, Suzanne Lyn Barker-Collo, Till Winfried Bärnighausen, Simon Barquera, Lope H Barrero, Quique Bassat, Sanjay Basu, Bernhard T Baune, Habtamu Wondifraw Baynes, Shahrzad Bazargan-Hejazi, Neeraj Bedi, Ettore Beghi, Masoud Behzadifar, Meysam Behzadifar, Yannick Béjot, Bayu Begashaw Bekele, Abate Bekele Belachew, Ezra Belay, Yihalem Abebe Belay, Michelle L Bell, Aminu K Bello, Derrick A Bennett, Isabela M Bensenor, Adam E Berman, Eduardo Bernabe, Robert S Bernstein, Gregory J Bertolacci, Mircea Beuran, Tina Beyranvand, Ashish Bhalla, Suraj Bhattarai, Soumyadeeep Bhaumik, Zulfiqar A Bhutta, Belete Biadgo, Molly H Biehl, Ali Bijani, Boris Bikbov, Ver Bilano, Nigus Bililign, Muhammad Shahdaat Bin Sayeed, Donal Bisanzio, Tuhin Biswas, Brigette F Blacker, Berrak Bora Basara, Rohan Borschmann, Cristina Bosetti, Kayvan Bozorgmehr, Oliver J Brady, Luisa C Brant, Carol Brayne, Alexandra Brazinova, Nicholas J K Breitborde, Hermann Brenner, Paul Svitil Briant, Gabrielle Britton, Traolach Brugha, Reinhard Busse, Zahid A Butt, Charlton S K H Callender, Ismael R Campos-Nonato, Julio Cesar Campuzano Rincon, Jorge Cano, Mate Car, Rosario Cárdenas, Giulia Carreras, Juan J Carrero, Austin Carter, Félix Carvalho, Carlos A Castañeda-Orjuela, Jacqueline Castillo Rivas, Chris D Castle, Clara Castro, Franz Castro, Ferrán Catalá-López, Ester Cerin, Yazan Chaiah, Jung-Chen Chang, Fiona J Charlson, Pankaj Chaturvedi, Peggy Pei-Chia Chiang, Odgerel Chimed-Ochir, Vesper Hichilombwe Chisumpa, Abdulaal Chitheer, Rajiv Chowdhury, Hanne Christensen, Devasahayam J Christopher, Sheng-Chia Chung, Flavia M Cicuttini, Liliana G Ciobanu, Massimo Cirillo, Aaron J Cohen, Leslie Trumbull Cooper, Paolo Angelo Cortesi, Monica Cortinovis, Ewerton Cousin, Benjamin C Cowie, Michael H Criqui, Elizabeth A Cromwell, Christopher Stephen Crowe, John A Crump, Matthew Cunningham, Alemneh Kabeta Daba, Abel Fekadu Dadi, Lalit Dandona, Rakhi Dandona, Anh Kim Dang, Paul I Dargan, Ahmad Daryani, Siddharth K Das, Rajat Das Gupta, José Das Neves, Tamirat Tesfaye Dasa, Aditya Prasad Dash, Adrian C Davis, Nicole Davis Weaver, Dragos Virgil Davitoiu, Kairat Davletov, Fernando Pio De La Hoz, Jan-Walter De Neve, Meaza Girma Degefa, Louisa Degenhardt, Tizta T Degfie, Selina Deiparine, Gebre Teklemariam Demoz, Balem Betsu Demtsu, Edgar Denova-Gutiérrez, Kebede Deribe, Nikolaos Dervenis, Don C Des Jarlais, Getenet Ayalew Dessie, Subhojit Dey, Samath D Dharmaratne, Daniel Dicker, Mesfin Tadese Dinberu, Eric L Ding, M Ashworth Dirac, Shirin Djalalinia, Klara Dokova, David Teye Doku, Christl A Donnelly, E Ray Dorsey, Pratik P Doshi, Dirk Douwes-Schultz, Kerrie E Doyle, Tim R Driscoll, Manisha Dubey, Eleonora Dubljanin, Eyasu Ejeta Duken, Bruce B Duncan, Andre R Duraes, Hedyeh Ebrahimi, Soheil Ebrahimpour, Dumessa Edessa, David Edvardsson, Anne Elise Eggen, Charbel El Bcheraoui, Maysaa El Sayed Zaki, Ziad El-Khatib, Hajer Elkout, Christian Lycke Ellingsen, Matthias Endres, Aman Yesuf Endries, Benjamin Er, Holly E Erskine, Babak Eshrati, Sharareh Eskandarieh, Reza Esmaeili, Alireza Esteghamati, Mahdi Fakhar, Hamed Fakhim, Mahbobeh Faramarzi, Mohammad Fareed, Farzaneh Farhadi, Carla Sofia E sá Farinha, Andre Faro, Maryam S Farvid, Farshad Farzadfar, Mohammad Hosein Farzaei, Valery L Feigin, Andrea B Feigl, Netsanet Fentahun, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Joao C Fernandes, Alize J Ferrari, Garumma Tolu Feyissa, Irina Filip, Samuel Finegold, Florian Fischer, Christina Fitzmaurice, Nataliya A Foigt, Kyle J Foreman, Carla Fornari, Tahvi D Frank, Takeshi Fukumoto, John E Fuller, Nancy Fullman, Thomas Fürst, João M Furtado, Neal D Futran, Silvano Gallus, Alberto L Garcia-Basteiro, Miguel A Garcia-Gordillo, William M Gardner, Abadi Kahsu Gebre, Tsegaye Tewelde Gebrehiwot, Amanuel Tesfay Gebremedhin, Bereket Gebremichael, Teklu Gebrehiwo Gebremichael, Tilayie Feto Gelano, Johanna M Geleijnse, Ricard Genova-Maleras, Yilma Chisha Dea Geramo, Peter W Gething, Kebede Embaye Gezae, Mohammad Rasoul Ghadami, Reza Ghadimi, Khalil Ghasemi Falavarjani, Maryam Ghasemi-Kasman, Mamata Ghimire, Katherine B Gibney, Paramjit Singh Gill, Tiffany K Gill, Richard F Gillum, Ibrahim Abdelmageed Ginawi, Maurice Giroud, Giorgia Giussani, Shifalika Goenka, Ellen M Goldberg, Srinivas Goli, Hector Gómez-Dantés, Philimon N Gona, Sameer Vali Gopalani, Taren M Gorman, Atsushi Goto, Alessandra C Goulart, Elena V Gnedovskaya, Ayman Grada, Giuseppe Grosso, Harish Chander Gugnani, Andre Luiz Sena Guimaraes, Yuming Guo, Prakash C Gupta, Rahul Gupta, Rajeev Gupta, Tanush Gupta, Reyna Alma Gutiérrez, Bishal Gyawali, Juanita A Haagsma, Nima Hafezi-Nejad, Tekleberhan B Hagos, Tewodros Tesfa Hailegiyorgis, Gessessew Bugssa Hailu, Arvin Haj-Mirzaian, Arya Haj-Mirzaian, Randah R Hamadeh, Samer Hamidi, Alexis J Handal, Graeme J Hankey, Hilda L Harb, Sivadasanpillai Harikrishnan, Josep Maria Haro, Mehedi Hasan, Hadi Hassankhani, Hamid Yimam Hassen, Rasmus Havmoeller, Roderick J Hay, Simon I Hay, Yihua He, Akbar Hedayatizadeh-Omran, Mohamed I Hegazy, Behzad Heibati, Mohsen Heidari, Delia Hendrie, Andualem Henok, Nathaniel J Henry, Claudiu Herteliu, Fatemeh Heydarpour, Pouria Heydarpour, Sousan Heydarpour, Desalegn Tsegaw Hibstu, Hans W Hoek, Michael K Hole, Enayatollah Homaie Rad, Praveen Hoogar, H Dean Hosgood, Seyed Mostafa Hosseini, Mehdi Hosseinzadeh, Mihaela Hostiuc, Sorin Hostiuc, Peter J Hotez, Damian G Hoy, Thomas Hsiao, Guoqing Hu, John J Huang, Abdullatif Husseini, Mohammedaman Mama Hussen, Susan Hutfless, Bulat Idrisov, Olayinka Stephen Ilesanmi, Usman Iqbal, Seyed Sina Naghibi Irvani, Caleb Mackay Salpeter Irvine, Nazrul Islam, Sheikh Mohammed Shariful Islam, Farhad Islami, Kathryn H Jacobsen, Leila Jahangiry, Nader Jahanmehr, Sudhir Kumar Jain, Mihajlo Jakovljevic, Moti Tolera Jalu, Spencer L James, Mehdi Javanbakht, Achala Upendra Jayatilleke, Panniyammakal Jeemon, Kathy J Jenkins, Ravi Prakash Jha, Vivekanand Jha, Catherine O Johnson, Sarah C Johnson, Jost B Jonas, Ankur Joshi, Jacek Jerzy Jozwiak, Suresh Banayya Jungari, Mikk Jürisson, Zubair Kabir, Rajendra Kadel, Amaha Kahsay, Rizwan Kalani, Manoochehr Karami, Behzad Karami Matin, André Karch, Corine Karema, Hamidreza Karimi-Sari, Amir Kasaeian, Dessalegn H Kassa, Getachew Mullu Kassa, Tesfaye Dessale Kassa, Nicholas J Kassebaum, Srinivasa Vittal Katikireddi, Anil Kaul, Zhila Kazemi, Ali Kazemi Karyani, Dhruv Satish Kazi, Adane Teshome Kefale, Peter Njenga Keiyoro, Grant Rodgers Kemp, Andre Pascal Kengne, Andre Keren, Chandrasekharan Nair Kesavachandran, Yousef Saleh Khader, Behzad Khafaei, Morteza Abdullatif Khafaie, Alireza Khajavi, Nauman Khalid, Ibrahim A Khalil, Ejaz Ahmad Khan, Muhammad Shahzeb Khan, Muhammad Ali Khan, Young-Ho Khang, Mona M Khater, Abdullah T Khoja, Ardeshir Khosravi, Mohammad Hossein Khosravi, Jagdish Khubchandani, Aliasghar A Kiadaliri, Getiye D Kibret, Zelalem Teklemariam Kidanemariam, Daniel N Kiirithio, Daniel Kim, Young-Eun Kim, Yun Jin Kim, Ruth W Kimokoti, Yohannes Kinfu, Adnan Kisa, Katarzyna Kissimova-Skarbek, Mika Kivimäki, Ann Kristin Skrindo Knudsen, Jonathan M Kocarnik, Sonali Kochhar, Yoshihiro Kokubo, Tufa Kolola, Jacek A Kopec, Parvaiz A Koul, Ai Koyanagi, Michael A Kravchenko, Kewal Krishan, Barthelemy Kuate Defo, Burcu Kucuk Bicer, G Anil Kumar, Manasi Kumar, Pushpendra Kumar, Michael J Kutz, Igor Kuzin, Hmwe Hmwe Kyu, Deepesh P Lad, Sheetal D Lad, Alessandra Lafranconi, Dharmesh Kumar Lal, Ratilal Lalloo, Tea Lallukka, Jennifer O Lam, Faris Hasan Lami, Van C Lansingh, Sonia Lansky, Heidi J Larson, Arman Latifi, Kathryn Mei-Ming Lau, Jeffrey V Lazarus, Georgy Lebedev, Paul H Lee, James Leigh, Mostafa Leili, Cheru Tesema Leshargie, Shanshan Li, Yichong Li, Juan Liang, Lee-Ling Lim, Stephen S Lim, Miteku Andualem Limenih, Shai Linn, Shiwei Liu, Yang Liu, Rakesh Lodha, Chris Lonsdale, Alan D Lopez, Stefan Lorkowski, Paulo A Lotufo, Rafael Lozano, Raimundas Lunevicius, Stefan Ma, Erlyn Rachelle King Macarayan, Mark T Mackay, Jennifer H MacLachlan, Emilie R Maddison, Fabiana Madotto, Hassan Magdy Abd El Razek, Muhammed Magdy Abd El Razek, Dhaval P Maghavani, Marek Majdan, Reza Majdzadeh, Azeem Majeed, Reza Malekzadeh, Deborah Carvalho Malta, Ana-Laura Manda, Luiz Garcia Mandarano-Filho, Helena Manguerra, Mohammad Ali Mansournia, Chabila Christopher Mapoma, Dadi Marami, Joemer C Maravilla, Wagner Marcenes, Laurie Marczak, Ashley Marks, Guy B Marks, Gabriel Martinez, Francisco Rogerlândio Martins-Melo, Ira Martopullo, Winfried März, Melvin B Marzan, Joseph R Masci, Benjamin Ballard Massenburg, Manu Raj Mathur, Prashant Mathur, Richard Matzopoulos, Pallab K Maulik, Mohsen Mazidi, Colm McAlinden, John J McGrath, Martin McKee, Brian J McMahon, Suresh Mehata, Man Mohan Mehndiratta, Ravi Mehrotra, Kala M Mehta, Varshil Mehta, Tefera C Mekonnen, Addisu Melese, Mulugeta Melku, Peter T N Memiah, Ziad A Memish, Walter Mendoza, Desalegn Tadese Mengistu, Getnet Mengistu, George A Mensah, Seid Tiku Mereta, Atte Meretoja, Tuomo J Meretoja, Tomislav Mestrovic, Haftay Berhane Mezgebe, Bartosz Miazgowski, Tomasz Miazgowski, Anoushka I Millear, Ted R Miller, Molly Katherine Miller-Petrie, G K Mini, Parvaneh Mirabi, Mojde Mirarefin, Andreea Mirica, Erkin M Mirrakhimov, Awoke Temesgen Misganaw, Habtamu Mitiku, Babak Moazen, Karzan Abdulmuhsin Mohammad, Moslem Mohammadi, Noushin Mohammadifard, Mohammed A Mohammed, Shafiu Mohammed, Viswanathan Mohan, Ali H Mokdad, Mariam Molokhia, Lorenzo Monasta, Ghobad Moradi, Maziar Moradi-Lakeh, Mehdi Moradinazar, Paula Moraga, Lidia Morawska, Ilais Moreno Velásquez, Joana Morgado-Da-Costa, Shane Douglas Morrison, Marilita M Moschos, Simin Mouodi, Seyyed Meysam Mousavi, Kindie Fentahun Muchie, Ulrich Otto Mueller, Satinath Mukhopadhyay, Kate Muller, John Everett Mumford, Jonah Musa, Kamarul Imran Musa, Ghulam Mustafa, Saravanan Muthupandian, Jean B Nachega, Gabriele Nagel, Aliya Naheed, Azin Nahvijou, Gurudatta Naik, Sanjeev Nair, Farid Najafi, Luigi Naldi, Hae Sung Nam, Vinay Nangia, Jobert Richie Nansseu, Bruno Ramos Nascimento, Gopalakrishnan Natarajan, 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Resnikoff, Satar Rezaei, Shahab Rezaeian, Mohammad Sadegh Rezai, Seyed Mohammad Riahi, Antonio Luiz P Ribeiro, Maria Jesus Rios-Blancas, Kedir Teji Roba, Nicholas L S Roberts, Stephen R Robinson, Leonardo Roever, Luca Ronfani, Gholamreza Roshandel, Ali Rostami, Dietrich Rothenbacher, Ambuj Roy, Enrico Rubagotti, Perminder S Sachdev, Basema Saddik, Ehsan Sadeghi, Hosein Safari, Mahdi Safdarian, Sare Safi, Saeid Safiri, Rajesh Sagar, Amirhossein Sahebkar, Mohammad Ali Sahraian, Nasir Salam, Joseph S Salama, Payman Salamati, Raphael De Freitas Saldanha, Zikria Saleem, Yahya Salimi, Sundeep Santosh Salvi, Inbal Salz, Evanson Zondani Sambala, Abdallah M Samy, Juan Sanabria, Maria Dolores Sanchez-Niño, Damian Francesco Santomauro, Itamar S Santos, João Vasco Santos, Milena M Santric Milicevic, Bruno Piassi Sao Jose, Abdur Razzaque Sarker, Rodrigo Sarmiento-Suárez, Nizal Sarrafzadegan, Benn Sartorius, Shahabeddin Sarvi, Brijesh Sathian, Maheswar Satpathy, Arundhati R Sawant, Monika Sawhney, Sonia Saxena, Mehdi Sayyah, Elke Schaeffner, Maria Inês Schmidt, Ione J C Schneider, Ben Schöttker, Aletta Elisabeth Schutte, David C Schwebel, Falk Schwendicke, James G Scott, Mario Sekerija, Sadaf G Sepanlou, Edson Serván-Mori, Seyedmojtaba Seyedmousavi, Hosein Shabaninejad, Katya Anne Shackelford, Azadeh Shafieesabet, Mehdi Shahbazi, Amira A Shaheen, Masood Ali Shaikh, Mehran Shams-Beyranvand, Mohammadbagher Shamsi, Morteza Shamsizadeh, Kiomars Sharafi, Mehdi Sharif, Mahdi Sharif-Alhoseini, Rajesh Sharma, Jun She, Aziz Sheikh, Peilin Shi, Mekonnen Sisay Shiferaw, Mika Shigematsu, Rahman Shiri, Reza Shirkoohi, Ivy Shiue, Farhad Shokraneh, Mark G Shrime, Si Si, Soraya Siabani, Tariq J Siddiqi, Inga Dora Sigfusdottir, Rannveig Sigurvinsdottir, Donald H Silberberg, Diego Augusto Santos Silva, João Pedro Silva, Natacha Torres Da Silva, Dayane Gabriele Alves Silveira, Jasvinder A Singh, Narinder Pal Singh, Prashant Kumar Singh, Virendra Singh, Dhirendra Narain Sinha, Karen Sliwa, Mari 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Werkneh, T Eoin West, Ronny Westerman, Harvey A Whiteford, Justyna Widecka, Lauren B Wilner, Shadrach Wilson, Andrea Sylvia Winkler, Charles Shey Wiysonge, Charles D A Wolfe, Shouling Wu, Yun-Chun Wu, Grant M A Wyper, Denis Xavier, Gelin Xu, Simon Yadgir, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Bereket Yakob, Lijing L Yan, Yuichiro Yano, Mehdi Yaseri, Yasin Jemal Yasin, Gökalp Kadri Yentür, Alex Yeshaneh, Ebrahim M Yimer, Paul Yip, Biruck Desalegn Yirsaw, Engida Yisma, Naohiro Yonemoto, Gerald Yonga, Seok-Jun Yoon, Marcel Yotebieng, Mustafa Z Younis, Mahmoud Yousefifard, Chuanhua Yu, Vesna Zadnik, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Zohreh Zare, Ayalew Jejaw Zeleke, Zerihun Menlkalew Zenebe, Anthony Lin Zhang, Kai Zhang, Maigeng Zhou, Sanjay Zodpey, Liesl Joanna Zuhlke, Mohsen Naghavi, and Christopher J L Murray., Rubagotti, Enrico, Abay, Solomon M., Roth, Gregory, Abd Allah, Foad, Abdela, Jemal, Abbastabar, Hedayat, and Abbasi, Nooshin

Subjects
Overview, Disease, Territory, Causes of death, humanities
Abstract

Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. The Lancet Publishing Group

Published
2019

12. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015

Author

Haidong, Wang, Mohsen, Naghavi, Christine, Allen, Ryan M, Barber Zulfi, qar A, Bhutta, Austin, Carter, Daniel C, Casey Fiona, J Charlson, Alan Zian, Chen Matthew, M Coates, Megan, Coggeshall, Lalit, Dandona, Daniel J, Dicker Holly, E Erskine, Alize J, Ferrari, Christina, Fitzmaurice, Kyle, Foreman, Mohammad H, Forouzanfar Maya, S Fraser, Nancy, Fullman, Peter W, Gething Ellen, M Goldberg, Nicholas, Graetz, Juanita A, Haagsma Simon, I Hay, Chantal, Huynh, Catherine O, Johnson Nicholas, J Kassebaum, Yohannes, Kinfu, Xie Rachel, Kulikoff, Michael, Kutz, Hmwe H, Kyu Heidi, J Larson, Janni, Leung, Xiaofeng, Liang, Stephen S, Lim, Margaret, Lind, Rafael, Lozano, Neal, Marquez, George A, Mensah, Joe, Mikesell, Ali H, Mokdad Meghan, D Mooney, Grant, Nguyen, Elaine, Nsoesie, David M, Pigott, Christine, Pinho, Gregory A, Roth Joshua, A Salomon, Logan, Sandar, Naris, Silpakit, Amber, Sligar, Reed J, D Sorensen, Jeff rey, Stanaway, Caitlyn, Steiner, Stephanie, Teeple, Bernadette A, Thomas, Christopher, Troeger, Amelia, VanderZanden, Stein Emil, Vollset, Valentine, Wanga, Harvey A, Whiteford, Timothy, Wolock, Leo, Zoeckler, Kalkidan Hassen, Abate, Cristiana, Abbafati, Kaja M, Abbas, Foad, Abd-Allah, Semaw Ferede, Abera Daisy, M X, Abreu Laith, J Abu-Raddad, Gebre Yitayih, Abyu, Tom, Achoki, Ademola Lukman, Adelekan Zanfi, na Ademi, Arsène Kouablan, Adou José, C Adsuar, Kossivi Agbelenko, Afanvi, Ashkan, Afshin, Emilie Elisabet, Agardh, Arnav, Agarwal, Anurag, Agrawal, Aliasghar Ahmad, Kiadaliri Oluremi, N Ajala, Ali Shafqat, Akanda Rufus, Olusola Akinyemi, Tomi F, Akinyemiju, Nadia, Akseer, Faris Hasan, Al Lami, Samer, Alabed, Ziyad, Al-Aly, Khurshid, Alam, Noore K, M Alam, Deena, Alasfoor, Saleh Fahed, Aldhahri Robert, William Aldridge, Miguel Angel, Alegretti Alicia, V Aleman, Zewdie Aderaw, Alemu Lily, T Alexander, Samia, Alhabib, Raghib, Ali, Ala’a, Alkerwi, François, Alla, Peter, Allebeck, Rajaa, Al-Raddadi, Ubai, Alsharif, Khalid A, Altirkawi Elena, Alvarez Martin, 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Subjects
VITAL-STATISTICS, INTEGRATED APPROACH, ECONOMIC-DEVELOPMENT, DEVELOPMENT ASSISTANCE, UNITED-STATES, Global Health, Communicable Disease, Communicable Diseases, cause of death, Medicine, General & Internal, Life Expectancy, General & Internal Medicine, Humans, Mortality, Medicine(all), Science & Technology, Mortality, Premature, Medicine (all), EPIDEMIOLOGIC TRANSITION, GBD 2015 Mortality and Causes of Death Collaborators, CIVIL REGISTRATION, Public Health, Global Health, Social Medicine and Epidemiology, Articles, 11 Medical And Health Sciences, ROAD TRAFFIC INJURIES, ALZHEIMERS-DISEASE, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, VERBAL AUTOPSY, Life Sciences & Biomedicine, Human
Abstract

Background Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures. Methods We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography-year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, life expectancy from birth increased from 61.7 years (95% uncertainty interval 61.4-61.9) in 1980 to 71.8 years (71.5-72.2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11.3 years (3.7-17.4), to 62.6 years (56.5-70.2). Total deaths increased by 4.1% (2.6-5.6) from 2005 to 2015, rising to 55.8 million (54.9 million to 56.6 million) in 2015, but age-standardised death rates fell by 17.0% (15.8-18.1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14.1% (12.6-16.0) to 39.8 million (39.2 million to 40.5 million) in 2015, whereas age-standardised rates decreased by 13.1% (11.9-14.3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42.1%, 39.1-44.6), malaria (43.1%, 34.7-51.8), neonatal preterm birth complications (29.8%, 24.8-34.9), and maternal disorders (29.1%, 19.3-37.1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000-183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000-532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death. Interpretation At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems. Copyright (C) The Author(s). Published by Elsevier Ltd.

Published
2016

13. Department of Error

Author

Maziar Moradi-Lakeh, Krishna K. Aryal, Mohamad-Hani Temsah, Ahmad Daryani, Claudio Alberto Davila, Achala Upendra Jayatilleke, David L. Smith, Chinwe Juliana Iwu, Kavumpurathu Raman Thankappan, Ibrahim Abdollahpour, Mehdi Fazlzadeh, Robert C. Reiner, Bineyam Taye, Dadi Marami, Ghulam Mustafa, Manasi Kumar, Mostafa Leili, Mehdi Sharif, Mohsen Naghavi, Maarten J. Postma, Chhabi Lal Ranabhat, Oluchi Okpala, Shivakumar K.M. Kondlahalli, Nihal Thomas, Man Mohan Mehndiratta, Ebrahim Babaee, Tsegaye Lolaso Lenjebo, Miliva Mozaffor, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, Meysam Behzadifar, Carlos Miguel Rios González, Pallab K. Maulik, Ali H. Mokdad, Mehran Alijanzadeh, Florian Fischer, Lalit Dandona, Aso Mohammad Darwesh, Alemayehu Toma Mena, Jennifer Rickard, Benjamin K. Mayala, Seyed Mostafa Mir, Moslem Soofi, Bhaskaran Unnikrishnan, Boris Bikbov, Bereket Duko Adema, Jagdish Khubchandani, Sachin R Atre, Rafael Moreira Claro, Sandra B. Munro, Carlos Zambrana-Torrelio, Kassawmar Angaw Bogale, Soraya Siabani, Muluken Azage Yenesew, Birhan Tamene Alemnew, Anwar E. Ahmed, Morteza Shamsizadeh, Masresha Tessema Anegago, Muluken Bekele Sorrie, Vivekanand Jha, Gebrekiros Gebremichael Meles, Andre M. N. Renzaho, Muhammad Aziz Rahman, Hebat Allah Salah A. Yousof, Naohiro Yonemoto, Ahmad Ghashghaee, Kebede Embaye Gezae, Hadi Pourjafar, Junaid Khan, Farnam Mohebi, Marcel Ausloos, Manisha Dubey, Quynh Anh P. Nguyen, Assefa Desalew, Vera Marisa Costa, Mohammad Fareed, Ronny Westerman, Maciej Banach, Paul S. F. Yip, Kala M. Mehta, Mehdi Yaseri, Quique Bassat, Amir Almasi-Hashiani, Fatemeh Rajati, Irina Filip, Gelin Xu, Derrick A Bennett, Atalay Goshu Muluneh, Leeberk Raja Inbaraj, Edgar Denova-Gutiérrez, Fariba Ghassemi, Behzad Karami Matin, David C. Schwebel, Syed Ather Hussain, Milena Ilic, Xiu Ju Zhao, Jost B. 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Kayode, Yafeng Wang, Ehsan Sadeghi, Behnam Heidari, Apurba Shil, Kamarul Imran Musa, Jagadish Rao Padubidri, Farshad Pourmalek, Saravanan Muthupandian, Navid Rabiee, Mario Poljak, Nima Hafezi-Nejad, Hagos Degefa Hidru, Jemal Abdu Mohammed, MohammadBagher Shamsi, Mohsen Asadi-Lari, Sameh Magdeldin, Berhe Etsay Tesfay, Khanh Bao Tran, James A Platts-Mills, Jan-Walter De Neve, Maria Jesus Rios-Blancas, Hedley Quintana, Félix Carvalho, Yun Jin Kim, Eric L. Ding, Noushin Mohammadifard, Saeed Safari, Addisu Melese, Rakesh Lodha, Reza Shirkoohi, Itamar S. Santos, Alireza Khatony, Mohammad Khazaei, Mekdes Tigistu Yilma, Taweewat Wiangkham, Hamed Kalani, Mayowa O. Owolabi, Mohammad Reza Sobhiyeh, Frank B. Osei, Narayan Bahadur Mahotra, Zewdie Aderaw Alemu, Konrad Pesudovs, Kewal Krishan, Samath D Dharmaratne, Ayalew Jejaw Zeleke, Osayomwanbo Osarenotor, Tina Beyranvand, Yahya Salimi, Winfried März, Sheikh Mohammed Shariful Islam, Azmeraw T. 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Abrigo, Arash Etemadi, Andrey Nikolaevich Briko, Nefsu Awoke, Anton Sokhan, Daniel Adane Endalew, Ibrahim Abdelmageed Ginawi, Jacek Jóźwiak, Mihajlo Jakovljevic, Degu Abate, Ali S. Shalash, Hamidreza Haririan, Lucas Guimarães Abreu, Davide Guido, Masoud Foroutan, Karzan Abdulmuhsin Mohammad, Niranjan Kissoon, Farkhonde Salehi, Ashish Awasthi, Hosein Shabaninejad, Trang Huyen Nguyen, Anthony Masaka, Getenet Dessie, Fakher Rahim, Aklilu Endalamaw, Kiana Ramezanzadeh, Farzad Manafi, Olayinka Stephen Ilesanmi, Vahid Alipour, Neeraj Bedi, Kimberly B. Johnson, Laurie B. Marczak, Mehran Shams-Beyranvand, Amira Shaheen, Zubair Kabir, Saleem Muhammad Rana, Marzieh Nojomi, Peter Njenga Keiyoro, Yared Asmare Aynalem, Tissa Wijeratne, Fiseha Wadilo Wada, Giuseppe Remuzzi, Carlo La Vecchia, Chuanhua Yu, Pascual R. Valdez, Senthilkumar Balakrishnan, Phetole Walter Mahasha, Liliana Preotescu, Tewodros Eshete Wonde, Keivan Ahmadi, Masood Ali Shaikh, Leticia Avila-Burgos, Ken Lee Chin, Dinh-Toi Chu, Francesco Saverio Violante, Yasir Waheed, Daniel Diaz, Rosario Cárdenas, Ibrahim A Khalil, Ernoiz Antriyandarti, Adrian Pana, Salman Rawaf, Nauman Khalid, Nejimu Biza Zepro, Turki Alanzi, Amir Jalali, Chukwudi A Nnaji, Kebadnew Mulatu Mihretie, Demelash Woldeyohannes Handiso, Nuruzzaman Khan, Takeshi Fukumoto, Christiane Dolecek, Melese Abate Reta, Vinay Nangia, Soumyadeep Bhaumik, Ravi Mehrotra, Seyed-Mohammad Fereshtehnejad, Brigette F. Blacker, Savita Lasrado, Seifadin Ahmed Shallo, Arash Ziapour, Krittika Bhattacharyya, Praveen Hoogar, Nicola Luigi Bragazzi, Mahdi Safdarian, Seyed Sina Naghibi Irvani, Chi Linh Hoang, Boikhutso Tlou, Manfred Accrombessi, Christopher J L Murray, Dragos Virgil Davitoiu, Hossein Poustchi, Farid Najafi, Sathish Thirunavukkarasu, Daniel Bekele Ketema, Dharmesh Kumar Lal, Vafa Rahimi-Movaghar, Christopher Troeger, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Paul H. Lee, Genet Melak Alamene, George C Patton, Andem Effiong, André Faro, Rushdia Ahmed, Colm McAlinden, Parvaneh Mirabi, Joshua Longbottom, Hagos Tasew Atalay, Alireza Rafiei, Somayeh Bohlouli, Temesgen Yihunie Akalu, Syed Mohamed Aljunid, Javad Nazari, Ismael R. Campos-Nonato, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Arvin Haj-Mirzaian, Sanghamitra Pati, Bakhtiar Piroozi, Rafael Alves Guimarães, Khaled Khatab, Evanson Z. Sambala, Mohsen Afarideh, Nelson Alvis-Guzman, Koku Sisay Tamirat, Mustafa Z. Younis, Hamed Zandian, Aparna Lal, Tamer H. Farag, Tahereh Pashaei, Benn Sartorius, Kidane Tadesse Gebremariam, Demelash Abewa Elemineh, Marwa Rashad Salem, Davide Rasella, Hedayat Abbastabar, Manu Raj Mathur, Peng Jia, Natalie Maria Cormier, Olatunde Aremu, Mohammad Reza Salahshoor, Kirsten E. Wiens, Ghobad Moradi, Srinivas Goli, Ruth W Kimokoti, Aliasghar Ahmad Kiadaliri, Khalid A Altirkawi, Ritesh G. Menezes, Molly K. Miller-Petrie, Alaa Badawi, Beriwan Abdulqadir Ali, Ensiyeh Jenabi, Getnet Azeze Gedefaw, Ahmed I. Hasaballah, Arash Tehrani-Banihashemi, Govinda Prasad Dhungana, Eleonora Dubljanin, Amir Hasanzadeh, Jasvinder A. Singh, Fereshteh Ansari, Dina Nur Anggraini Ningrum, Feleke Mekonnen Demeke, Agus Sudaryanto, Muhammad Ali, Yilma Chisha Dea Geramo, Leonardo Roever, Gebreamlak Gebremedhn Gebremeskel, Maheswar Satpathy, Asnakew Achaw Ayele, Seyyed Meysam Mousavi, Devasahayam J. Christopher, Malede Mequanent Sisay, Yibeltal Alemu Bekele, Tamirat Tesfaye Dasa, Gessessew Bugssa Hailu, Luca Ronfani, James Albright, Nathaniel J. Henry, Ionut Negoi, Dessalegn Ajema Berbada, Brijesh Sathian, Yousef Khader, Bal Govind Chauhan, Nikolay Ivanovich Briko, Hamideh Salimzadeh, Ali Bijani, Irfan Ullah, Shirin Djalalinia, Shanshan Li, Kebreab Paulos, Mohsen Bayati, Nasir Salam, Mohammad Ali Mansournia, Rajesh Sagar, Fatemeh Heydarpour, Siamak Sabour, Theo Vos, Tuomo J. Meretoja, Ireneous N. Soyiri, Mathew M. Baumann, Mehedi Hasan, Vishnu Renjith, Nuno Taveira, Getaneh Alemu Abebe, Pranab Chatterjee, Shafiu Mohammed, Dongyu Zhang, Abbas Mosapour, Muki Shey, Rajat Das Gupta, Muktar Beshir Ahmed, Satar Rezaei, Wondimeneh Shibabaw Shiferaw, Kenean Getaneh Tlaye, Eugenio Traini, Oladimeji Adebayo, Aisha Elsharkawy, David M. Pigott, Hadi Hassankhani, Anas M. Saad, Mohammad Rabiee, Sivan Yegnanarayana Iyer Saraswathy, Abdallah M. Samy, Ali Talha Khalil, Nelson G.M. Gomes, Afsaneh Arzani, Ayesha Humayun, Michael Tamene Haile, Huyen Phuc Do, Maryam Khayamzadeh, Rajeev Gupta, Davoud Adham, Farah Daoud, Jai K Das, Ana Isabel Ribeiro, Sameer Vali Gopalani, Joel M. Francis, Alyssa N. Sbarra, Brian J. Hall, Ravi Prakash Jha, David Teye Doku, Guoqing Hu, Erkin M. Mirrakhimov, Seyed Hossein Yahyazadeh Jabbari, S. Mohammad Sajadi, Shankar M Bakkannavar, Ali Yadollahpour, Masoud Behzadifar, and G Anil Kumar

Subjects
Burden of disease, 030219 obstetrics & reproductive medicine, business.industry, Low income and middle income countries, General Medicine, Specific mortality, 030204 cardiovascular system & hematology, Article, 3. Good health, 03 medical and health sciences, Geography, 0302 clinical medicine, Environmental health, Medicine, 030212 general & internal medicine, Geographical inequalities, business, Demography
Abstract

Reiner RC Jr, Hay SI. Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000–17: analysis for the Global Burden of Disease Study 2017. Lancet 2020; 395: 1779–801—In this Article, the author byline has been amended to Local Burden of Disease Diarrhoea Collaborators. This correction has been made to the online version as of June 4, 2020, and the printed version is correct. © 2020 Elsevier Ltd

Published
2018

14. Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980-2015 : a systematic analysis for the Global Burden of Disease Study 2015

Author

Vasiliki Stathopoulou, Kiran Thapa, Vesper Hichilombwe Chisumpa, Azeem Majeed, Hjalte Holm Andersen, Devasahayam J. Christopher, Alireza Mohammadi, John J. McGrath, Konstantin Kazanjan, Naohiro Yonemoto, Guoqing Hu, Yousef Khader, Suzanne Barker-Collo, Frida Namnyak Ngalesoni, Jennifer O Lam, Laetitia Huiart, Xiaofeng Liang, Amanuel Tesfay Gebremedhin, Lalit Dandona, Felix Masiye, Joseph R Fitchett, Derrick A Bennett, Rosana E. Norman, Theo Vos, Tuomo J. Meretoja, Rahman Shiri, Melvin Barrientos Marzan, Charles R. Newton, Kelly Cercy, Masoud Vaezghasemi, Elena Alvarez Martin, Christopher Troeger, Ismael R. Campos-Nonato, Amany H Refaat, Ruben Castro, Amiran Gamkrelidze, Michael R. Phillips, Samath D Dharmaratne, Reed J D Sorensen, Roderick J. Hay, Johan Ärnlöv, Ivo Rakovac, Alexandra Brazinova, Nancy Fullman, Sara Sheikhbahaei, Liliana G Ciobanu, Nader Jahanmehr, Yuming Guo, Luigi Naldi, Rana Jawad Asghar, Tsegaye Tewelde Gebrehiwot, Corine Karema, Biju Abraham, Rynaz H S Rabiee, Emerito Jose A. Faraon, Philimon Gona, Jonathan I. Silverberg, Alexandria Brown, Kovin Naidoo, Suleman Atique, Yun Jin Kim, Benn Sartorius, Hwashin Hyun Shin, George Mugambage Ruhago, Adugnaw Berhane, Tesfaye Tekle, Abdur Rahman Khan, Vipin Gupta, Nima Hafezi-Nejad, Héctor Gómez-Dantés, Jun She, Ted R. Miller, Tolesa Bekele, Yohannes Kinfu, Srinivas Murthy, Alaa Badawi, Mahfuzar Rahman, Raghib Ali, Robert G. Weintraub, Nicholas Steel, Khalid A Altirkawi, Muhammad Imran Nisar, Man Mohan Mehndiratta, Thomas N. Williams, Adrian Davis, Usha Ram, Nobuyuki Horita, Qingyang Xiao, Bishal Gyawali, Burcu Kucuk Bicer, Eun-Kee Park, Subas Neupane, Mohammad Tavakkoli, Lorenzo Monasta, Roman Topor-Madry, Marc-Alain Widdowson, James Leigh, Padukudru Anand Mahesh, Stephen M. Amrock, Stefan Ma, Virendra Singh, Amir Kasaeian, Mahdi Mahdavi, Shahrzad Bazargan-Hejazi, Kim Moesgaard Iburg, Vafa Rahimi-Movaghar, Julio Cesar Campuzano, Maria Dolores Sanchez-Niño, Jean B. Nachega, Hamid Asayesh, Pratik Pinal Doshi, Charles Shey Wiysonge, Peter J. Hotez, Ying Jiang, Girma Temam Shifa, Warren D. Lo, Francis Apolinary Mhimbira, Joan B. Soriano, Ritul Kamal, Young-Ho Khang, Isaac Akinkunmi Adedeji, Daniel C Casey, Adeladza Kofi Amegah, Demewoz Haile, Tomi Akinyemiju, Andrew L. Thorne-Lyman, Achala Upendra Jayatilleke, Rajeev Gupta, Rosario Cárdenas, Peter W. Gething, Ami R. Moore, Marie Ng, Maigeng Zhou, Ferrán Catalá-López, Anders Larsson, Ratilal Lalloo, Panniyammakal Jeemon, Bach Xuan Tran, Chigozie Jesse Uneke, Marina Shakh-Nazarova, Jamie Hancock, Yohannes Adama Melaku, Jasvinder A. Singh, Isabela M. Benseñor, Shafiu Mohammed, Rajiv Chowdhury, Hedyeh Ebrahimi, Yoshihiro Kokubo, Belinda K Lloyd, Samir Bhatt, Geoffrey Buckle, Tissa Wijeratne, Giuseppe Remuzzi, Robert W Aldridge, Luca Ronfani, Raj Kumar Verma, Jagdish Khubchandani, Irma Khonelidze, Ai Koyanagi, Teshome Gebre, Michael Kutz, Om Prakash Singh, Ana Maria Nogales Vasconcelos, Margaret Lind, Svetlana Popova, Hmwe H Kyu, Tom Achoki, Laith J. Abu-Raddad, Zacharie Tsala Dimbuene, Henock Yebyo, Mehdi Yaseri, Max Petzold, Sungho Won, Semaw Ferede Abera, Devina Nand, Rafael Tabarés-Seisdedos, Abdishakur M. Abdulle, Yingfeng Zheng, Soewarta Kosen, Aleksandra Barac, Mahboubeh Parsaeian, Yuichiro Yano, Charles D.A. Wolfe, Simon I. Hay, Luke D. Knibbs, Balem Demtsu Betsu, Solomon Abrha Damtew, Ileana Heredia-Pi, Boris Bikbov, Bemnet Amare Tedla, Daniel Kim, Ulrich O Mueller, Khurshid Alam, Andrew H. Kemp, Austin Carter, Chuanhua Yu, Ibrahim A Khalil, João Mário Pedro, Atsushi Goto, Arsène Kouablan Adou, Scott B. Patten, Nicola Low, Julio Cesar Montañez Hernandez, Heidi J. Larson, Worku Tefera, Sanjay Zodpey, Kalpana Balakrishnan, Hsing-Yi Chang, Jacqueline Castillo Rivas, Donal Bisanzio, Hilda L Harb, Meghan D. Mooney, John N Newton, Vasiliy Victorovich Vlassov, Marcella Montico, Mojde Mirarefin, Vinay Nangia, Edgar P. Simard, Ben Schöttker, Michael Brainin, Ziad A. Memish, Rafael Lozano, Damian G Hoy, Gebre Yitayih Abyu, Alexis J Handal, Saleem M Rana, Francesco Saverio Violante, Monika Sawhney, Eyal Oren, Iqbal R. F. Elyazar, Oluremi N Ajala, Christopher J L Murray, Chioma Ezinne Chibueze, Rupert R A Bourne, Euripide Frinel G Arthur Avokpaho, Andreas A Kudom, Hilton Lam, Aman Yesuf Endries, Farshad Pourmalek, Andre Pascal Kengne, Gholamreza Roshandel, Chandrashekhar T Sreeramareddy, Bolajoko O. Olusanya, Tommi Vasankari, Zahid A Butt, Alemseged Aregay Gebru, Samer Hamidi, Soraya Seedat, Xie Rachel Kulikoff, Maziar Moradi-Lakeh, Gelin Xu, Shireen Sindi, Ruoyan Tobe-Gai, Haidong Wang, Johanna M. Geleijnse, Rajesh Kumar Rai, Ryan M Barber, André Karch, Ione Jayce Ceola Schneider, Hebe N. Gouda, Sibhatu Biadgilign, Erika Ota, Kerrie E. Doyle, Olalekan A. Uthman, Jed D. Blore, Walid Ammar, Guohong Jiang, Carlos A Castañeda-Orjuela, Ibrahim Abubakar, Konstantinos Stroumpoulis, Megan Coggeshall, Charles N Mock, Ronan A Lyons, Jose Martinez-Raga, Thomas Fürst, Ambuj Roy, Mustafa Z. Younis, Harish Chander Gugnani, Mohammad Hifz Ur Rahman, Lidia Morawska, Noore Alam, Paul S. F. Yip, Grant Nguyen, Randah R. Hamadeh, Victor Aboyans, Miloje Savic, Ketevan Gambashidze, Graeme J. Hankey, David M. Pereira, Cho-il Kim, Peter A. Meaney, Haidong Kan, Sameer Vali Gopalani, Murugesan Raju, Saeid Shahraz, Ibrahim Abdelmageem Mohamed Ginawi, Kenji Shibuya, Raimundas Lunevicius, Sun Ha Jee, Prashant Singh, Atte Meretoja, Suzanne Polinder, Alex Reynolds, Joseph Mikesell, David O. Carpenter, Carla Sofia e Sa Farinha, Miguel Angel Alegretti, Nataliya Foigt, Naris Silpakit, Amare Deribew, Gessessew Bugssa Hailu, Mohammed Magdy Abd El Razek, Reza Assadi, Yichong Li, Georgina A. V. Murphy, Babak Eshrati, Rintaro Mori, Scott Weichenthal, Andre Keren, Van C. Lansingh, Kebede Deribe, Bulat Idrisov, François Alla, Maaya Kita, Ala'a Alkerwi, Maia Kereselidze, Yanping Wang, Rajesh Sharma, Florian Fischer, Foluke Adetola Ojelabi, Maya S Fraser, Kingsley N. Ukwaja, H. Dean Hosgood, Puja Rao, Deena Alasfoor, Muhammad Muhammad Saleh, Bryan L. Sykes, Juan Sanabria, Ronny Westerman, Julian David Pillay, Cassandra Szoeke, Umar Bacha, Edward J Mills, Manisha Dubey, Aliya Naheed, Al Artaman, Jiabin Shen, Michael Burch, Reza Malekzadeh, Hans W. Hoek, David C. Schwebel, Alireza Esteghamati, Seok Jun Yoon, Leilei Duan, Matthew M Coates, Arnav Agarwal, Soumya Swaminathan, Quyen Nguyen, Hye-Youn Park, Peter Nguhiu, Bereket Yakob, Patrick Liu, Elisabeth Barboza França, Tigist Assefa Bayou, Azmeraw T. Amare, Farshad Farzadfar, Tariku Jibat, Jost B. Jonas, Kaja Abbas, Thomas Truelsen, Maryam S. Farvid, Louisa Degenhardt, George A. Mensah, Till Bärnighausen, Ivy Shuie, Jee-Young Jasmine Choi, Amitava Banerjee, Zubair Kabir, Ingrid Wolfe, Patrick Martial Nkamedjie Pete, Preet K Dhillon, Kathryn H. Jacobsen, Sadaf G. Sepanlou, Gagandeep Kang, Aminu K. Bello, Bineyam Taye, Mohsen Naghavi, Chhabi Lal Ranabhat, Walter Mendoza, M. Patrice Lindsay, Sergey K Vladimirov, Tesfaye Setegn, Angel J Paternina Caicedo, Eric L. Ding, Narayanaswamy Venketasubramanian, Stephen S Lim, Barthelemy Kuate Defo, Alan D. Lopez, G Anil Kumar, João C. Fernandes, In-Hwan Oh, Rasmus Havmoeller, Amanuel Alemu Abajobir, Pengpeng Ye, Gabrielle deVeber, Espen Bjertness, Hao Zhang, Ali H. Mokdad, Yogeshwar Kalkonde, Peter Memiah, Rodrigo Sarmiento-Suarez, Konrad Pesudovs, Yong Zhao, Joseph Friedman, Abdullah Sulieman Terkawi, Hadi Danawi, André Faro, Kevin N. Sheth, Abera Kenay Tura, Sajjad Ur Rahman, Sergey Soshnikov, Ajit Kumar Yadav, Michelle L. Bell, Nelson Alvis-Guzman, Miia Kivipelto, Pieter de Jager, Yongmei Li, Giancarlo Logroscino, Sivadasanpillai Harikrishnan, Talha Farid, Zewdie Aderaw Alemu, Alemayehu Amberbir, Niveen M E Abu-Rmeileh, Beatriz Paulina Ayala Quintanilla, Parvaiz A Koul, Edson Serván-Mori, Anil Kaul, Cheng Huang, Kalkidan Hassen Abate, Hsiang Huang, Foad Abd-Allah, Marek Majdan, Sait Mentes Birlik, Jung-Chen Chang, Rahul Gupta, Luciano A. Sposato, Sergey Petrovich Ermakov, Ejaz Ahmad Khan, Yibeltal Tebekaw Bayou, Christian Lycke Ellingsen, Ole Frithjof Norheim, Zulfiqar A Bhutta, Hajo Zeeb, Norberto Perico, Jun Zhu, Bruno F. Sunguya, Parthasarathi Ganguly, Fisaha Haile Tesfay, Min-Jeong Shin, Ashish Awasthi, Felix Akpojene Ogbo, Alan J Thomson, Mostafa Qorbani, Ye Jin, Don C. Des Jarlais, Itamar S. Santos, Juanita A. Haagsma, Anwar Rafay, Jacob Olusegun Olusanya, José Neves, Gregory M Anderson, Amador Goodridge, Bolanle F Banigbe, David Rojas-Rueda, Pedro R. Olivares, Rakhi Dandona, Stefanos Tyrovolas, Peter Njenga Keiyoro, Stein Emil Vollset, Andrea Werdecker, Mohamed Hsairi, Chandrasekharan Nair Kesavachandran, Jeanne Françoise Kayibanda, Alemayehu B. Mekonnen, Addisu Shunu Beyene, Lela Sturua, Inga Dora Sigfusdottir, Amber Sligar, Maysaa El Sayed Zaki, Shiwei Liu, Melkamu Dedefo Gishu, Chantal Huynh, Lope H Barrero, Linhong Wang, Neeraj Bedi, Masood Ali Shaikh, Ricky Leung, Mehdi Javanbakht, Alemayehu Hailu, Kimani M Harun, Ubai Alsharif, Richard C. Franklin, Zoubida Zaidi, Hassan Magdy Abd El Razek, Masako Horino, Karzan Abdulmuhsin Mohammad, Diego Augusto Santos Silva, Marcello Tonelli, Juan Jesus Carrero, Cyrus Cooper, Rajaa Al-Raddadi, Juan Liang, Leslie Cornaby, Awoke Misganaw, Norito Kawakami, Carl Abelardo T. Antonio, Daniel J. Weiss, Abhishek Singh, Vivekanand Jha, Seyed-Mohammad Fereshtehnejad, Serge Resnikoff, Gizachew Assefa Tessema, Alem Mehari, Wagner Marcenes, Chabila C Mapoma, Ababi Zergaw Giref, Farhad Pishgar, Khassoum Diallo, Nicholas J K Breitborde, Emmanuel A. Ameh, Justin Beardsley, Ademola Lukman Adelekan, Joshua A. Salomon, Mamo Wubshet, Diego De Leo, Daniel Pope, Elisabete Weiderpass, Gregory A. Roth, Niranjan Kissoon, Kaire Innos, João Vasco Santos, Rajesh Sagar, Bradford D. Gessner, Akindele Olupelumi Adebiyi, John J Huang, Dharmesh Kumar Lal, Samantha M. Colquhoun, Eduardo Bernabé, Nadia Akseer, Maheswar Satpathy, Fotis Topouzis, Health Services Management & Organisation (HSMO), Public Health, Psychiatry, Neurology, Wang, Haidong, Bhutta, Zulfiqar A, Coates, Matthew M, Coggeshall, M, Ciobanu, Liliana G, Murray, Christopher JL, Coggeshall, Megan, Dandona, Lalit, Diallo, Khassoum, Franca, Elisabeth Barboza, Fraser, Maya, Fullman, Nancy, Gething, Peter W, Hay, Simon I, Kinfu, Yohanne, Kita, Maaya, Kulikoff, Xie Rachel, Larson, Heidi J, Liang, Juan, Liang, Xiaofeng, Lind, Margaret, Lopez, Alan D, Lozano, Rafael, Mensah, George A, Mikesell, Joseph B, Mokdad, Ali H, Mooney, Meghan D, Nguyen, Grant, Rakovac, Ivo, Salomon, Joshua A, Silpakit, Nari, Sligar, Amber, Sorensen, Reed J D, Vos, Theo, Zhu, Jun, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbas, Kaja M, Abd-Allah, Foad, Abdulle, Abdishakur M, Abera, Semaw Ferede, Aboyans, Victor, Abraham, Biju, Abubakar, Ibrahim, Abu-Raddad, Laith J, Abu-Rmeileh, Niveen M E, Abyu, Gebre Yitayih, Achoki, Tom, Adebiyi, Akindele Olupelumi, Adedeji, Isaac Akinkunmi, Adelekan, Ademola Lukman, Adou, Arsène Kouablan, Agarwal, Arnav, Ajala, Oluremi N, Akinyemiju, Tomi F, Akseer, Nadia, Alam, Khurshid, Alam, Noore K M, Alasfoor, Deena, Aldridge, Robert William, Alegretti, Miguel Angel, Alemu, Zewdie Aderaw, Ali, Raghib, Alkerwi, Ala'A, Alla, Françoi, Al-Raddadi, Rajaa, Alsharif, Ubai, Altirkawi, Khalid A, Martin, Elena Alvarez, Alvis-Guzman, Nelson, Amare, Azmeraw T, Amberbir, Alemayehu, Amegah, Adeladza Kofi, Ameh, Emmanuel A, Ammar, Walid, Amrock, Stephen Marc, Andersen, Hjalte H, Anderson, Gregory M, Antonio, Carl Abelardo T, Ärnlöv, Johan, Artaman, Al, Asayesh, Hamid, Asghar, Rana Jawad, Assadi, Reza, Atique, Suleman, Avokpaho, Euripide Frinel G Arthur, Awasthi, Ashish, Quintanilla, Beatriz Paulina Ayala, Bacha, Umar, Badawi, Alaa, Balakrishnan, Kalpana, Banerjee, Amitava, Banigbe, Bolanle F, Barac, Aleksandra, Barber, Ryan M, Barker-Collo, Suzanne L, Bärnighausen, Till, Barrero, Lope H, Bayou, Tigist Assefa, Bayou, Yibeltal Tebekaw, Bazargan-Hejazi, Shahrzad, Beardsley, Justin, Bedi, Neeraj, Bekele, Tolesa, Bell, Michelle L, Bello, Aminu K, Bennett, Derrick A, Bensenor, Isabela M, Berhane, Adugnaw, Bernabé, Eduardo, Betsu, Balem Demtsu, Bhatt, Samir, Biadgilign, Sibhatu, Bikbov, Bori, Birlik, Sait Mente, Bisanzio, Donal, Bjertness, Espen, Blore, Jed D, Bourne, Rupert R A, Brainin, Michael, Brazinova, Alexandra, Breitborde, Nicholas J K, Brown, Alexandria, Buckle, Geoffrey Colin, Burch, Michael, Butt, Zahid A, Campos-Nonato, Ismael Ricardo, Campuzano, Julio Cesar, Cárdenas, Rosario, Carpenter, David O, Carrero, Juan Jesu, Carter, Austin, Casey, Daniel C, Castañeda-Orjuela, Carlos A, Rivas, Jacqueline Castillo, Castro, Ruben Estanislao, Catalá-López, Ferrán, Cercy, Kelly, Chang, Hsing-Yi, Chang, Jung-Chen, Chibueze, Chioma Ezinne, Chisumpa, Vesper Hichilombwe, Choi, Jee-Young Jasmine, Chowdhury, Rajiv, Christopher, Devasahayam Jesuda, Colquhoun, Samantha M, 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Bradford D, Ginawi, Ibrahim Abdelmageem Mohamed, Giref, Ababi Zergaw, Gishu, Melkamu Dedefo, Gomez-Dantes, Hector, Gona, Philimon, Goodridge, Amador, Gopalani, Sameer Vali, Goto, Atsushi, Gouda, Hebe N, Gugnani, Harish Chander, Guo, Yuming, Gupta, Rahul, Gupta, Rajeev, Gupta, Vipin, Gyawali, Bishal, Haagsma, Juanita A, Hafezi-Nejad, Nima, Haile, Demewoz, Hailu, Alemayehu Desalegne, Hailu, Gessessew Bugssa, Hamadeh, Randah Ribhi, Hancock, Jamie, Handal, Alexis J, Hankey, Graeme J, Harb, Hilda L, Harikrishnan, Sivadasanpillai, Harun, Kimani M, Havmoeller, Rasmu, Hay, Roderick J, Heredia-Pi, Ileana Beatriz, Hoek, Hans W, Horino, Masako, Horita, Nobuyuki, Hosgood, H Dean, Hotez, Peter J, Hoy, Damian G, Hsairi, Mohamed, Hu, Guoqing, Huang, Cheng, Huang, John J, Huang, Hsiang, Huiart, Laetitia, Iburg, Kim Moesgaard, Idrisov, Bulat T, Innos, Kaire, Jacobsen, Kathryn H, Jahanmehr, Nader, Javanbakht, Mehdi, Jayatilleke, Achala Upendra, Jee, Sun Ha, Jeemon, Panniyammakal, Jha, Vivekanand, Jiang, Guohong, Jiang, Ying, Jibat, Tariku, Jin, Ye, Jonas, Jost B, Kabir, Zubair, Kalkonde, Yogeshwar, Kamal, Ritul, Kan, Haidong, Kang, Gagandeep, Karch, André, Karema, Corine Kakizi, Kasaeian, Amir, Kaul, Anil, Kawakami, Norito, Kayibanda, Jeanne Françoise, Kazanjan, Konstantin, Keiyoro, Peter Njenga, Kemp, Andrew Haddon, Kengne, Andre Pascal, Keren, Andre, Kereselidze, Maia, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khalil, Ibrahim A, Khan, Abdur Rahman, Khan, Ejaz Ahmad, Khang, Young-Ho, Khonelidze, Irma, Khubchandani, Jagdish, Kim, Cho-il, Kim, Daniel, Kim, Yun Jin, Kissoon, Niranjan, Kivipelto, Miia, Knibbs, Luke D, Kokubo, Yoshihiro, Kosen, Soewarta, Koul, Parvaiz A, Koyanagi, Ai, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kudom, Andreas A, Kumar, G Anil, Kyu, Hmwe H, Lal, Dharmesh Kumar, Lalloo, Ratilal, Lam, Hilton, Lam, Jennifer O, Lansingh, Van C, Larsson, Ander, Leigh, Jame, Leung, Ricky, Li, Yichong, Li, Yongmei, Lindsay, M Patrice, Liu, Patrick Y, Liu, Shiwei, Lloyd, Belinda K, Lo, Warren D, Logroscino, Giancarlo, Low, Nicola, Lunevicius, Raimunda, Lyons, Ronan A, Ma, Stefan, Razek, Hassan Magdy Abd El, Razek, Mohammed Magdy Abd El, Mahdavi, Mahdi, Majdan, Marek, Majeed, Azeem, Malekzadeh, Reza, Mapoma, Chabila C, Marcenes, Wagner, Martinez-Raga, Jose, Marzan, Melvin Barriento, Masiye, Felix, Mcgrath, John J, Meaney, Peter A, Mehari, Alem, Mehndiratta, Man Mohan, Mekonnen, Alemayehu B, Melaku, Yohannes Adama, Memiah, Peter, Memish, Ziad A, Mendoza, Walter, Meretoja, Atte, Meretoja, Tuomo J, Mhimbira, Francis Apolinary, Miller, Ted R, Mills, Edward J, Mirarefin, Mojde, Misganaw, Awoke, Mock, Charles N, Mohammad, Karzan Abdulmuhsin, Mohammadi, Alireza, Mohammed, Shafiu, Monasta, Lorenzo, Hernandez, Julio Cesar Montañez, Montico, Marcella, Moore, Ami R, Moradi-Lakeh, Maziar, Morawska, Lidia, Mori, Rintaro, Mueller, Ulrich O, Murphy, Georgina A V, Murthy, Sriniva, Nachega, Jean B, Naheed, Aliya, Naidoo, Kovin S, Naldi, Luigi, Nand, Devina, Nangia, Vinay, Neupane, Suba, Newton, Charles R, Newton, John N, Ng, Marie, Ngalesoni, Frida Namnyak, Nguhiu, Peter, Nguyen, Quyen Le, Nisar, Muhammad Imran, Pete, Patrick Martial Nkamedjie, Norheim, Ole F, Norman, Rosana E, Ogbo, Felix Akpojene, Oh, In-Hwan, Ojelabi, Foluke Adetola, Olivares, Pedro R, Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Oren, Eyal, Ota, Erika, Pa, Mahesh, Park, Eun-Kee, Park, Hye-Youn, Parsaeian, Mahboubeh, Caicedo, Angel J Paternina, Patten, Scott B, Pedro, João Mário, Pereira, David M, Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Phillips, Michael Robert, Pillay, Julian David, Pishgar, Farhad, Polinder, Suzanne, Pope, Daniel, Popova, Svetlana, Pourmalek, Farshad, Qorbani, Mostafa, Rabiee, Rynaz H S, Rafay, Anwar, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Sajjad Ur, Rai, Rajesh Kumar, Raju, Murugesan, Ram, Usha, Rana, Saleem M, Ranabhat, Chhabi Lal, Rao, Puja, Refaat, Amany H, Remuzzi, Giuseppe, Resnikoff, Serge, Reynolds, Alex, Rojas-Rueda, David, Ronfani, Luca, Roshandel, Gholamreza, Roth, Gregory A, Roy, Ambuj, Ruhago, George Mugambage, Sagar, Rajesh, Saleh, Muhammad Muhammad, Sanabria, Juan R, Sanchez-Niño, Maria Dolore, Santos, Itamar S, Santos, João Vasco, Sarmiento-Suarez, Rodrigo, Sartorius, Benn, Satpathy, Maheswar, Savic, Miloje, Sawhney, Monika, Schneider, Ione J C, Schöttker, Ben, Schwebel, David C, Seedat, Soraya, Sepanlou, Sadaf G, Servan-Mori, Edson E, Setegn, Tesfaye, Shahraz, Saeid, Shaikh, Masood Ali, Shakh-Nazarova, Marina, Sharma, Rajesh, She, Jun, Sheikhbahaei, Sara, Shen, Jiabin, Sheth, Kevin N, Shibuya, Kenji, Shin, Hwashin Hyun, Shin, Min-Jeong, Shiri, Rahman, Shuie, Ivy, Sigfusdottir, Inga Dora, Silva, Diego Augusto Santo, Silverberg, Jonathan, Simard, Edgar P, Sindi, Shireen, Singh, Abhishek, Singh, Jasvinder A, Singh, Om Prakash, Singh, Prashant Kumar, Singh, Virendra, Soriano, Joan B, Soshnikov, Sergey, Sposato, Luciano A, Sreeramareddy, Chandrashekhar T, Stathopoulou, Vasiliki, Steel, Nichola, Stroumpoulis, Konstantino, Sturua, Lela, Sunguya, Bruno F, Swaminathan, Soumya, Sykes, Bryan L, Szoeke, Cassandra E I, Tabarés-Seisdedos, Rafael, Tavakkoli, Mohammad, Taye, Bineyam, Tedla, Bemnet Amare, Tefera, Worku Mekonnen, Tekle, Tesfaye, Shifa, Girma Temam, Terkawi, Abdullah Sulieman, Tesfay, Fisaha Haile, Tessema, Gizachew Assefa, Thapa, Kiran, Thomson, Alan J, Thorne-Lyman, Andrew L, Tobe-Gai, Ruoyan, Tonelli, Marcello, Topor-Madry, Roman, Topouzis, Foti, Tran, Bach Xuan, Troeger, Christopher, Truelsen, Thoma, Dimbuene, Zacharie Tsala, Tura, Abera Kenay, Tyrovolas, Stefano, Ukwaja, Kingsley N, Uneke, Chigozie Jesse, Uthman, Olalekan A, Vaezghasemi, Masoud, Vasankari, Tommi, Vasconcelos, Ana Maria Nogale, Venketasubramanian, Narayanaswamy, Verma, Raj Kumar, Violante, Francesco S, Vladimirov, Sergey K, Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Wang, Linhong, Wang, Yanping, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G, Weiss, Daniel J, Werdecker, Andrea, Westerman, Ronny, Widdowson, Marc-Alain, Wijeratne, Tissa, Williams, Thomas Neil, Wiysonge, Charles Shey, Wolfe, Charles D A, Wolfe, Ingrid, Won, Sungho, Wubshet, Mamo, Xiao, Qingyang, Xu, Gelin, Yadav, Ajit Kumar, Yakob, Bereket, Yano, Yuichiro, Yaseri, Mehdi, Ye, Pengpeng, Yebyo, Henock Gebremedhin, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa Z, Yu, Chuanhua, Zaidi, Zoubida, Zaki, Maysaa El Sayed, Zeeb, Hajo, Zhang, Hao, Zhao, Yong, Zheng, Yingfeng, Zhou, Maigeng, Zodpey, Sanjay, and Murray, Christopher J L

Subjects
Pediatrics, Nutrition and Disease, Global Health, Communicable Disease, 0302 clinical medicine, Voeding en Ziekte, Infant Mortality, Compensation law of mortality, Global health, Medicine, LIFE EXPECTANCY, 030212 general & internal medicine, DEVELOPING-COUNTRIES, 10. No inequality, Medicine(all), NEWBORN BABIES, Medicine (all), Mortality rate, 1. No poverty, DEATH, Public Health, Global Health, Social Medicine and Epidemiology, General Medicine, 11 Medical And Health Sciences, Stillbirth, 3. Good health, Child Mortality, SURVIVAL, CHILD-MORTALITY, HEALTH, Life Sciences & Biomedicine, DEVELOPMENT GOAL 4, Human, INTERVENTIONS, medicine.medical_specialty, RJ, INTEGRATED APPROACH, Developing country, Communicable Diseases, neonatal, 03 medical and health sciences, Medicine, General & Internal, 030225 pediatrics, General & Internal Medicine, Life Science, Humans, Global Burden of Disease Study, VLAG, Estimation, Science & Technology, business.industry, Klinisk medicin, Infant, GBD 2015 Child Mortality Collaborators, Infant mortality, Malaria, Child mortality, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Life expectancy, Clinical Medicine, RG, business, Demography
Abstract

BACKGROUND: Established in 2000, Millennium Development Goal 4 (MDG4) catalysed extraordinary political, financial, and social commitments to reduce under-5 mortality by two-thirds between 1990 and 2015. At the country level, the pace of progress in improving child survival has varied markedly, highlighting a crucial need to further examine potential drivers of accelerated or slowed decreases in child mortality. The Global Burden of Disease 2015 Study (GBD 2015) provides an analytical framework to comprehensively assess these trends for under-5 mortality, age-specific and cause-specific mortality among children under 5 years, and stillbirths by geography over time. METHODS: Drawing from analytical approaches developed and refined in previous iterations of the GBD study, we generated updated estimates of child mortality by age group (neonatal, post-neonatal, ages 1-4 years, and under 5) for 195 countries and territories and selected subnational geographies, from 1980-2015. We also estimated numbers and rates of stillbirths for these geographies and years. Gaussian process regression with data source adjustments for sampling and non-sampling bias was applied to synthesise input data for under-5 mortality for each geography. Age-specific mortality estimates were generated through a two-stage age-sex splitting process, and stillbirth estimates were produced with a mixed-effects model, which accounted for variable stillbirth definitions and data source-specific biases. For GBD 2015, we did a series of novel analyses to systematically quantify the drivers of trends in child mortality across geographies. First, we assessed observed and expected levels and annualised rates of decrease for under-5 mortality and stillbirths as they related to the Soci-demographic Index (SDI). Second, we examined the ratio of recorded and expected levels of child mortality, on the basis of SDI, across geographies, as well as differences in recorded and expected annualised rates of change for under-5 mortality. Third, we analysed levels and cause compositions of under-5 mortality, across time and geographies, as they related to rising SDI. Finally, we decomposed the changes in under-5 mortality to changes in SDI at the global level, as well as changes in leading causes of under-5 deaths for countries and territories. We documented each step of the GBD 2015 child mortality estimation process, as well as data sources, in accordance with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). FINDINGS: Globally, 5·8 million (95% uncertainty interval [UI] 5·7-6·0) children younger than 5 years died in 2015, representing a 52·0% (95% UI 50·7-53·3) decrease in the number of under-5 deaths since 1990. Neonatal deaths and stillbirths fell at a slower pace since 1990, decreasing by 42·4% (41·3-43·6) to 2·6 million (2·6-2·7) neonatal deaths and 47·0% (35·1-57·0) to 2·1 million (1·8-2·5) stillbirths in 2015. Between 1990 and 2015, global under-5 mortality decreased at an annualised rate of decrease of 3·0% (2·6-3·3), falling short of the 4·4% annualised rate of decrease required to achieve MDG4. During this time, 58 countries met or exceeded the pace of progress required to meet MDG4. Between 2000, the year MDG4 was formally enacted, and 2015, 28 additional countries that did not achieve the 4·4% rate of decrease from 1990 met the MDG4 pace of decrease. However, absolute levels of under-5 mortality remained high in many countries, with 11 countries still recording rates exceeding 100 per 1000 livebirths in 2015. Marked decreases in under-5 deaths due to a number of communicable diseases, including lower respiratory infections, diarrhoeal diseases, measles, and malaria, accounted for much of the progress in lowering overall under-5 mortality in low-income countries. Compared with gains achieved for infectious diseases and nutritional deficiencies, the persisting toll of neonatal conditions and congenital anomalies on child survival became evident, especially in low-income and low-middle-income countries. We found sizeable heterogeneities in comparing observed and expected rates of under-5 mortality, as well as differences in observed and expected rates of change for under-5 mortality. At the global level, we recorded a divergence in observed and expected levels of under-5 mortality starting in 2000, with the observed trend falling much faster than what was expected based on SDI through 2015. Between 2000 and 2015, the world recorded 10·3 million fewer under-5 deaths than expected on the basis of improving SDI alone. INTERPRETATION: Gains in child survival have been large, widespread, and in many places in the world, faster than what was anticipated based on improving levels of development. Yet some countries, particularly in sub-Saharan Africa, still had high rates of under-5 mortality in 2015. Unless these countries are able to accelerate reductions in child deaths at an extraordinary pace, their achievement of proposed SDG targets is unlikely. Improving the evidence base on drivers that might hasten the pace of progress for child survival, ranging from cost-effective intervention packages to innovative financing mechanisms, is vital to charting the pathways for ultimately ending preventable child deaths by 2030. FUNDING: Bill & Melinda Gates Foundation. Erratum: Department of Error, The Lancet,Volume 389, Issue 10064, 2017, Page e1. DOI: 10.1016/S0140-6736(16)32608-3

Published
2016

15. Injury-related gaining momentum as external causes of deaths in Ethiopian health and demographic surveillance sites: evidence from verbal autopsy study

Author

Gessessew Bugssa Hailu, Nega Assefa, Kassahun Alemu Gelaye, Desalew Zelalem, Wubegzier Mekonnen, Fasil Tessema, Gashaw Andargie Biks, Semaw Ferede Abera, Mekdes Kondal, Mamo Wubshet Terefe, Firehywot Eshetu, Befikadu Tariku, Mulumebet Abera, Mitike Molla Sisay, Yoseph Fekadu, Mesfin Kote, Etsehiwot Tilahun, Alemseged Aregay Gebru, Yihunie Lakew, and Melkamu Dedefo

Subjects
Male, verbal autopsy, Poison control, Suicide prevention, Occupational safety and health, 0302 clinical medicine, Cause of Death, Medicine, 030212 general & internal medicine, Child, lcsh:Public aspects of medicine, Health Policy, Human factors and ergonomics, Middle Aged, Research Design, Child, Preschool, Population Surveillance, Female, Original Article, Autopsy, Adult, Adolescent, Injury control, Article, Young Adult, 03 medical and health sciences, Age Distribution, Momentum (finance), Environmental health, Injury prevention, Humans, assault, suicide, Aged, Drowning, business.industry, Infant, Newborn, Public Health, Environmental and Occupational Health, Infant, lcsh:RA1-1270, 030208 emergency & critical care medicine, mortality, Verbal autopsy, Socioeconomic Factors, external causes, Accidents, transport, Wounds and Injuries, Ethiopia, business
Abstract

Background: In Ethiopia, though all kinds of mortality due to external causes are an important component of overall mortality often not counted or documented on an individual basis. Objective: The aim of this study was to describe the patterns of mortality from external causes using verbal autopsy (VA) method at the Ethiopian HDSS Network sites. Methods: All deaths at Ethiopian HDSS sites were routinely registered and followed up with VA interviews. The VA forms comprised deaths up to 28 days, between four weeks and 14 years and 15 years and above. The cause of a death was ascertained based on an interview with next of families or other caregivers using a standardized questionnaire that draws information on signs, symptoms, medical history and circumstances preceding death after 45 days mourning period. Two physician assigned probable causes of death as underlying, immediate and contributing factors independently using information in VA forms based on the WHO ICD-10 and VA code system. Disagreed cases sent to third physician for independent review and diagnosis. The final cause of death considered when two of the three physicians assigned underlying cause of death; otherwise, labeled as undetermined. Results: In the period from 2009 to 2013, a total of 9719 deaths were registered. Of the total deaths, 623 (6.4%) were from external causes. Of these, accidental drowning and submersion, 136 (21.8%), accidental fall, 113 (18.1%) and transport-related accidents, 112 (18.0%) were the topmost three leading external causes of deaths. About 436 (70.0%) of deaths were from the age group above 15 years old. Drowning and submersion and transport-related accidents were high in age group between 5 and 14 years old. Conclusion: In this study, external causes of death are significant public health problems and require attention as one of prior health agenda.

Published
2018

16. Correction to Lancet HIV 2016; 3: e361–87

Author

Kerrie E. Doyle, Olalekan A. Uthman, Laxmikant Chavan, Azmeraw T. Amare, Rasmus Havmoeller, Maryam S. Farvid, Louisa Degenhardt, Mohamed Hsairi, Kimani M Harun, Zoubida Zaidi, Hassan Magdy Abd El Razek, Masako Horino, Rajesh Sagar, Bradford D. Gessner, Bongani M. Mayosi, Konrad Pesudovs, Man Mohan Mehndiratta, Sadaf G. Sepanlou, Akindele Olupelumi Adebiyi, Hye Youn Park, Alexandria Brown, Charles Shey Wiysonge, Bach Xuan Tran, Haidong Kan, Ajit Kumar Yadav, Arsène Kouablan Adou, Karzan Abdulmuhsin Mohammad, In-Hwan Oh, Juan Jesus Carrero, Pratik Pinal Doshi, Panniyammakal Jeemon, Teshome Gebre, Abdullah Sulieman Terkawi, Vasiliki Stathopoulou, Hsing-Yi Chang, Bulat Idrisov, Azeem Majeed, Yoshihiro Kokubo, Zahid A Butt, Yuichiro Yano, Nataliya Foigt, Naris Silpakit, Rajesh Kumar Rai, Rajaa Mohammad, Alireza Esteghamati, Seok Jun Yoon, Kathryn H. Jacobsen, Carl Abelardo T. Antonio, Sibhatu Biadgilign, Ruoyan Tobe-Gai, Balem Demtsu Betsu, Haidong Wang, Samir Soneji, Devasahayam J. Christopher, Ileana Heredia-Pi, Boris Bikbov, John Q. Wong, Yun Jin Kim, Giancarlo Logroscino, Raimundas Lunevicius, Eesh Bhatia, Kazem Rahimi, Sajjad Ur Rahman, Henock Yebyo, Mehdi Yaseri, Rodrigo Sarmiento-Suarez, Yong Zhao, Joseph Friedman, André Faro, Nelson Alvis-Guzman, Yongmei Li, Bemnet Amare Tedla, Wanqing Chen, Shafiu Mohammed, Vivekanand Jha, Achala Upendra Jayatilleke, Guoqing Hu, Yousef Khader, Rafael Alfonso-Cristancho, Girma Temam Shifa, Suzanne Polinder, Bryan L. Sykes, Kaja Abbas, Nadia Akseer, Rakhi Dandona, Aleksandra Barac, Simon I. Hay, Scott B. Patten, Jiabin Shen, Donal Bisanzio, Hilda L Harb, Gizachew Assefa Tessema, Wagner Marcenes, Chabila C Mapoma, Miia Kivipelto, Hsiang Huang, Jung-Chen Chang, P. V. Rao, Amanda J. Mason-Jones, Bolajoko O. Olusanya, Hilton Lam, Amare Deribew, Saleem M Rana, Mohammad Taghi Hedayati, Khurshid Alam, Reza Malekzadeh, Mohamed Magdy Abd El Razek, Mojde Mirarefin, Juan Sanabria, Umar Bacha, Rashmi Gupta, Laith J. Abu-Raddad, Amanuel Tesfay Gebremedhin, Felix Masiye, Maurice Giroud, Palwasha Anwari, Sergey Petrovich Ermakov, Ole Frithjof Norheim, Zulfiqar A Bhutta, Rosario Cárdenas, John J Huang, Alaa Badawi, Edward J Mills, Guohong Jiang, Matthew M Coates, Martin McKee, Jacqueline Castillo Rivas, Norito Kawakami, Chandrashekhar T Sreeramareddy, Mohammad Tavakkoli, Pieter de Jager, Hajo Zeeb, Tim Driscoll, James Leigh, Mohammad Yahya Saeedi, Gelin Xu, Rana J. Asghar, Koranteng Adofo, Sivadasanpillai Harikrishnan, Zewdie Aderaw Alemu, Roberto Tchio Talongwa, Jeanne Françoise Kayibanda, Tuomo J. Meretoja, Alemseged Aregay Gebru, Yuantao Hao, Bereket Yakob, Melvin Barrientos Marzan, Jose Martinez-Raga, Rosana E. Norman, Gebre Yitayih Abyu, Anders Larsson, Dayane Gabriele Alves Silveira, Sasa Rajsic, Elena Alvarez, Nikolaos Tsilimparis, Kenji Shibuya, Alexandra Brazinova, Nader Jahanmehr, Solomon Abreha Damtew, Ambuj Roy, Elisabete Weiderpass, Derrick A Bennett, Holly Hagan, Julio Cesar Campuzano, Shifalika Goenka, Gudlavalleti V S Murthy, Mirriam Chibalabala, Mostafa Qorbani, Peter Njenga Keiyoro, Stein Emil Vollset, Andrea Werdecker, Sanjay Zodpey, Alemayehu B. Mekonnen, Addisu Shunu Beyene, Stephen M. Amrock, Soewarta Kosen, Haseeb Nawaz, Tukur Dahiru, Gessessew Bugssa Hailu, Atsushi Goto, Abdur Rahman Khan, Vipin Gupta, Nima Hafezi-Nejad, Parvaiz A Koul, John Nelson Opio, Jun She, Michael Brainin, Luke Nyakarahuka, Edson Serván-Mori, Dimitris Karletsos, Chandrasekharan Nair Kesavachandran, Van C. Lansingh, Ala'a Alkerwi, Elizabeth Glaser, Ziad A. Memish, Sinead Langan, Usha Ram, Alicia Aleman, Brighton Murimira, Jae-Hyun Park, Foluke Adetola Ojelabi, Anil Kaul, Foad Abd-Allah, Aman Yesuf Endries, Erika Ota, Mark Drew Crosland Guimarães, Rajesh Sharma, Mahdi Mahdavi, Andre Pascal Kengne, Joan B. Soriano, Soumya Swaminathan, Ritul Kamal, Quyen Nguyen, Felix Akpojene Ogbo, Alan J Thomson, Don C. Des Jarlais, Sara Sheikhbahaei, Al Artaman, Chigozie Jesse Uneke, Tsegaye Tewelde Ghiwot, Maya S Fraser, Veena S. Kulkarni, Corine Karema, Samer Hamidi, Randah R. Hamadeh, Marek Majdan, Sait Mentes Birlik, Mihajlo Jakovljevic, Kingsley N. Ukwaja, Jeffrey A. Towbin, Tariku Jibat, Julian David Pillay, Suleman Atique, Raghib Ali, Shicheng Yu, Carlos A. Castañeda-Orjuela, Nobuyuki Horita, Graeme J. Hankey, Prashant Singh, Mouhanad Hammami, Nicholas Steel, Yohannes Kinfu, Hao Zhang, Niveen M E Abu-Rmeileh, François Alla, Johanna M. Geleijnse, Nancy Fullman, Rintaro Mori, Ying Jiang, Semaw Ferede Abera, Atte Meretoja, Katherine Pearson, Robert G. Weintraub, Zubair Kabir, Juanita A. Haagsma, Muhammad Imran Nisar, Benn Sartorius, Lalit Dandona, Amir Kasaeian, Andrew H. Kemp, Melkamu Dedefo Gishu, Ferrán Catalá-López, Deena Alasfoor, Isaac Akinkunmi Adedeji, Hwashin Hyun Shin, Peter Memiah, Muhammad Muhammad Saleh, Mahfuzar Rahman, Yohannes Adama Melaku, Barthelemy Kuate Defo, Alan D. Lopez, Meghan D. Mooney, Inga Dora Sigfusdottir, Walid Ammar, Vegard Skirbekk, David M. Prokop, Edgar P. Simard, Jagdish Khubchandani, Fortuné Gbètoho Gankpé, Arindam Basu, Roman Topor-Madry, Walter Mendoza, Amador Goodridge, G Anil Kumar, Jean de Dieu Ngirabega, Amanuel Alemu Abajobir, João C. Fernandes, Michael Burch, Gholamreza Roshandel, Leo Zoeckler, Ai Koyanagi, Emmanuel Peprah, Maysaa El Sayed Zaki, Shiwei Liu, Shireen Sindi, Adam Trickey, Ali H. Mokdad, William Msemburi, James D. Wilkinson, Rafael Tabarés-Seisdedos, Sungho Won, Abdishakur M. Abdulle, Ted R. Miller, Oluremi N Ajala, Karen Sliwa, Linhong Wang, Awoke Misganaw Temesgen, Jasvinder A. Singh, Kaire Innos, Fisaha Haile Tesfay, Steven E. Lipshultz, Belinda Lloyd, Burcu Kucuk Bicer, Vasiliy Victorovich Vlassov, Maziar Moradi-Lakeh, Abera Kenay Tura, Adeladza Kofi Amegah, Peggy Pei-Chia Chiang, Charles D.A. Wolfe, Ulrich O Mueller, Francis Apolinary Mhimbira, Nicholas J K Breitborde, Monika Sawhney, Eyal Oren, Kim Moesgaard Iburg, Vafa Rahimi-Movaghar, Tomi Akinyemiju, Tissa Wijeratne, Giuseppe Remuzzi, Alemayehu Amberbir, Itamar S. Santos, Ibrahim A Khalil, Aliya Naheed, Anwar Rafay, Beatriz Paulina Ayala Quintanilla, Saleh F. Aldhahri, Jacob Olusegun Olusanya, André Karch, Harish Chander Gugnani, Mohammad Hifz Ur Rahman, Ronny Westerman, Vinod K. Paul, Dietrich Plass, David Rojas-Rueda, Reza Assadi, Tigist Assefa Bayou, Vinay Nangia, Ayalnesh Zemene Yalew, Eric L. Ding, Justin Beardsley, Veena R. Iyer, Stephen S Lim, Bineyam Taye, Till Bärnighausen, Ademola Lukman Adelekan, Joshua A. Salomon, Chakib Nejjari, Josep Maria Haro, Diego De Leo, Faris Lami, Sameer Vali Gopalani, Om P. Singh, Farshad Farzadfar, Kalkidan Hassen Abate, Ejaz Ahmad Khan, Yibeltal Tebekaw Bayou, Norberto Perico, Bruno F. Sunguya, Narayanaswamy Venketasubramanian, Ashish Awasthi, Lorenzo Monasta, David O Soti, Hamid Asayesh, Young-Ho Khang, Thomas Fürst, Hmwe H Kyu, Heidi J. Larson, Amber Sligar, Mahesh Anand Padukudru, Ricky Leung, Reed J D Sorensen, Farshad Pourmalek, Liliana G Ciobanu, Luigi Naldi, Kiran Thapa, Vesper Hichilombwe Chisumpa, Yousef M. Elshrek, Naohiro Yonemoto, Frida Namnyak Ngalesoni, Jennifer O Lam, Neeraj Bedi, Masood Ali Shaikh, Iqbal R. F. Elyazar, Soraya Seedat, Mehdi Javanbakht, Paul S. F. Yip, Grant Nguyen, Peter A. Meaney, Joseph Mikesell, Kebede Deribe, Johan Ärnlöv, Emmanuela Gakidou, Robert W Aldridge, Joseph Robert Ander Fitchett, José das Neves, Ubai Alsharif, Diego Augusto Santos Silva, Cyrus Cooper, H. Dean Hosgood, Seyed-Mohammad Fereshtehnejad, Liesl Zühlke, Dharmesh Kumar Lal, Tim M. Wolock, David M. Pereira, Carla Sofia e Sa Farinha, Miguel Angel Alegretti, Babak Eshrati, Paulo A. Lotufo, Salem Al-Raddadi, Christopher J L Murray, Austin Carter, Rajeev Gupta, Jee-Young Jasmine Choi, Mustafa Z. Younis, Michael R. Phillips, Snehal Patil, Samath D Dharmaratne, Robert P. Dellavalle, George Mugambage Ruhago, Tesfaye Tekle, Shahrzad Bazargan-Hejazi, Peter W. Gething, Isabela M. Benseñor, Zacharie Tsala Dimbuene, Max Petzold, Chuanhua Yu, Ziyad Al-Aly, Ibrahim Abubakar, Noore Alam, Aletta E. Schutte, Andrew L. Thorne-Lyman, Denis Nash, Luca Ronfani, Manisha Dubey, Lydia S. Atkins, Hans W. Hoek, David C. Schwebel, Jost B. Jonas, Carla Makhlouf, Sergey K Vladimirov, Damian G Hoy, Euripide Frinel G Arthur Avokpaho, Florian Fischer, and Imad D A Faghmous

Subjects
Burden of disease, medicine.medical_specialty, Operations research, Epidemiology, business.industry, Incidence (epidemiology), Immunology, Human immunodeficiency virus (HIV), medicine.disease, medicine.disease_cause, Infectious Diseases, Acquired immunodeficiency syndrome (AIDS), Virology, Family medicine, Medicine, business
Abstract

© 2016 Elsevier Ltd GBD 2015 HIV Collaborators. Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2015: the Global Burden of Disease Study 2015. Lancet HIV 2016; 3: e361–87—In this Article, Kerrie E Doyle and David M Pereira have been added to the list of collaborators and Claudia C Pereira has been removed. These corrections have been made as of Aug 22, 2016.

Published
2016

17. Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015

Author

Roth, Gregory A., Johnson, Catherine, Abajobir, Amanuel, Abd-Allah, Foad, Abera, Semaw Ferede, Abyu, Gebre, Ahmed, Muktar, Aksut, Baran, Alam, Tahiya, Alam, Khurshid, Alla, Francois, Alvis-Guzman, Nelson, Amrock, Stephen, Ansari, Hossein, Arnlov, Johan, Asayesh, Hamid, Atey, Tesfay Mehari, Avila-Burgos, Leticia, Awasthi, Ashish, Banerjee, Amitava, Barac, Aleksandra, Barnighausen, Till, Barregard, Lars, Bedi, Neeraj, Ketema, Ezra Belay, Bennett, Derrick, Berhe, Gebremedhin, Bhutta, Zulfiqar, Bitew, Shimelash, Carapetis, Jonathan, Carrero, Juan Jesus, Malta, Deborah Carvalho, Andres Castaneda-Orjuela, Carlos, Castillo-Rivas, Jacqueline, Catala-Lopez, Ferran, Choi, Jee-Young, Christensen, Hanne, Cirillo, Massimo, Cooper, Leslie, Criqui, Michael, Cundiff, David, Damasceno, Albertino, Dandona, Lalit, Dandona, Rakhi, Davletov, Kairat, Dharmaratne, Samath, Dorairaj, Prabhakaran, Dubey, Manisha, Ehrenkranz, Rebecca, Zaki, Maysaa El Sayed, Faraon, Emerito Jose A., Esteghamati, Alireza, Farid, Talha, Farvid, Maryam, Feigin, Valery, Ding, Eric L., Fowkes, Gerry, Gebrehiwot, Tsegaye, Gillum, Richard, Gold, Audra, Gona, Philimon, Gupta, Rajeev, Habtewold, Tesfa Dejenie, Hafezi-Nejad, Nima, Hailu, Tesfaye, Hailu, Gessessew Bugssa, Hankey, Graeme, Hassen, Hamid Yimam, Abate, Kalkidan Hassen, Havmoeller, Rasmus, Hay, Simon I., Horino, Masako, Hotez, Peter J., Jacobsen, Kathryn, James, Spencer, Javanbakht, Mehdi, Jeemon, Panniyammakal, John, Denny, Jonas, Jost, Kalkonde, Yogeshwar, Karimkhani, Chante, Kasaeian, Amir, Khader, Yousef, Khan, Abdur, Khang, Young-Ho, Khera, Sahil, Khoja, Abdullah T., Khubchandani, Jagdish, Kim, Daniel, Kolte, Dhaval, Kosen, Soewarta, Krohn, Kristopher J., Kumar, G. Anil, Kwan, Gene F., Lal, Dharmesh Kumar, Larsson, Anders, Linn, Shai, Lopez, Alan, Lotufo, Paulo A., Abd El Razek, Hassan Magdy, Malekzadeh, Reza, Mazidi, Mohsen, Meier, Toni, Meles, Kidanu Gebremariam, Mensah, George, Meretoja, Atte, Mezgebe, Haftay, Miller, Ted, Mirrakhimov, Erkin, Mohammed, Shafiu, Moran, Andrew E., Musa, Kamarul Imran, Narula, Jagat, Neal, Bruce, Ngalesoni, Frida, Grant Nguyen, Obermeyer, Carla Makhlouf, Owolabi, Mayowa, Patton, George, Pedro, Joao, Qato, Dima, Qorbani, Mostafa, Rahimi, Kazem, Rai, Rajesh Kumar, Rawaf, Salman, Ribeiro, Antonio, Safiri, Saeid, Salomon, Joshua A., Santos, Itamar, Milicevic, Milena Santric, Sartorius, Benn, Schutte, Aletta, Sepanlou, Sadaf, Shaikh, Masood Ali, Shin, Min-Jeong, Shishehbor, Mehdi, Shore, Hirbo, Santos Silva, Diego Augusto, Sobngwi, Eugene, Stranges, Saverio, Swaminathan, Soumya, Tabares-Seisdedos, Rafael, Atnafu, Niguse Tadele, Tesfay, Fisaha, Thakur, J. S., Thrift, Amanda, Topor-Madry, Roman, Truelsen, Thomas, Tyrovolas, Stefanos, Ukwaja, Kingsley Nnanna, Uthman, Olalekan, Vasankari, Tommi, Vlassov, Vasiliy, Vollset, Stein Emil, Wakayo, Tolassa, Watkins, David, Weintraub, Robert, Werdecker, Andrea, Westerman, Ronny, Wiysonge, Charles Shey, Wolfe, Charles, Workicho, Abdulhalik, Xu, Gelin, Yano, Yuichiro, Yip, Paul, Yonemoto, Naohiro, Younis, Mustafa, Yu, Chuanhua, Vos, Theo, Naghavi, Mohsen, Murray, Christopher, Roth, Gregory, Johnson, Catherine, Abajobir, Amanuel, Abd-Allah, Foad, Semaw, Ferede Abera, Gebre, Abyu, Muktar, Ahmed, Baran, Aksut, Tahiya, Alam, Khurshid, Alam, François, Alla, Nelson, Alvis-Guzman, Stephen, Amrock, Hossein, Ansari, Johan, Ärnlöv, Hamid, Asayesh, Tesfay, Mehari Atey, Leticia, Avila-Burgo, Ashish, Awasthi, Amitava, Banerjee, Aleksandra, Barac, Till, Bärnighausen, Lars, Barregard, Neeraj, Bedi, Ezra, Belay Ketema, Derrick, Bennett, Gebremedhin, Berhe, Zulfiqar, Bhutta, Shimelash, Bitew, Jonathan, Carapeti, Juan, Jesus Carrero, Deborah, Carvalho Malta, Carlos, Andres Castañeda-Orjuela, Jacqueline, Castillo-Riva, Ferrán, Catalá-López, Jee-Young, Choi, Hanne, Christensen, Cirillo, Massimo, Leslie, Cooper, Michael, Criqui, David, Cundiff, Albertino, Damasceno, Lalit, Dandona, Rakhi, Dandona, Kairat, Davletov, Samath, Dharmaratne, Prabhakaran, Dorairaj, Manisha, Dubey, Rebecca, Ehrenkranz, Maysaa, El Sayed Zaki, Emerito, Jose A. Faraon, Alireza, Esteghamati, Talha, Farid, Maryam, Farvid, Valery, Feigin, Eric, L. Ding, Gerry, Fowke, Tsegaye, Gebrehiwot, Richard, Gillum, Audra, Gold, Philimon, Gona, Rajeev, Gupta, Tesfa, Dejenie Habtewold, Nima, Hafezi-Nejad, Tesfaye, Hailu, Gessessew, Bugssa Hailu, Graeme, Hankey, Hamid, Yimam Hassen, Kalkidan, Hassen Abate, Rasmus, Havmoeller, Simon, Hay, Masako, Horino, Peter, Hotez, Kathryn, Jacobsen, Spencer, Jame, Mehdi, Javanbakht, Panniyammakal, Jeemon, Denny, John, Jost, Jona, Yogeshwar, Kalkonde, Chante, Karimkhani, Amir, Kasaeian, Yousef, Khader, Abdur, Khan, Young-Ho, Khang, Sahil, Khera, Abdullah, Khoja, Jagdish, Khubchandani, Daniel, Kim, Dhaval, Kolte, Soewarta, Kosen, Kristopher, Krohn, Anil, Kumar, Gene, Kwan, Dharmesh, Kumar Lal, Anders, Larsson, Shai, Linn, Alan, Lopez, Paulo, Lotufo, Hassan, Magdy, Abd El, Razek, Reza, Malekzadeh, Mohsen, Mazidi, Toni, Meier, Kidanu, Gebremariam Mele, George, Mensah, Atte, Meretoja, Haftay, Mezgebe, Ted, Miller, Erkin, Mirrakhimov, Shafiu, Mohammed, Andrew, Moran, Kamarul, Imran Musa, Jagat, Narula, Bruce, Neal, Frida, Ngalesoni, Grant, Nguyen, Carla, Makhlouf Obermeyer, Mayowa, Owolabi, George, Patton, João, Pedro, Dima, Qato, Mostafa, Qorbani, Kazem, Rahimi, Rajesh, Kumar Rai, Salman, Rawaf, Antônio, Ribeiro, Saeid, Safiri, Joshua, Salomon, Itamar, Santo, Milena, Santric Milicevic, Benn, Sartoriu, Aletta, Schutte, Sadaf, Sepanlou, Masood, Ali Shaikh, Min-Jeong, Shin, Mehdi, Shishehbor, Hirbo, Shore, Diego, Augusto Santos Silva, Eugene, Sobngwi, Saverio, Strange, Soumya, Swaminathan, Rafael, Tabarés-Seisdedo, Niguse, Tadele Atnafu, Fisaha, Tesfay Thakur, Amanda, Thrift, Roman, Topor-Madry, Thomas, Truelsen, Stefanos, Tyrovola, Kingsley, Nnanna Ukwaja, Olalekan, Uthman, Tommi, Vasankari, Vasiliy, Vlassov, Stein, Emil Vollset, Tolassa, Wakayo, David, Watkin, Robert, Weintraub, Andrea, Werdecker, Ronny, Westerman, Charles, Shey Wiysonge, Charles, Wolfe, Abdulhalik, Workicho, Gelin, Xu, Yuichiro, Yano, Paul, Yip, Naohiro, Yonemoto, Mustafa, Youni, Chuanhua, Yu, Theo, Vo, Mohsen, Naghavi, and Christopher, Murray.

Subjects
Adult, Male, Cardiac & Cardiovascular Systems, DEATHS, global health, Risk Assessment, 1102 Cardiovascular Medicine And Haematology, LOW-INCOME COUNTRIES, Young Adult, cause of death, Life Expectancy, Risk Factors, AMERICAN-HEART-ASSOCIATION, SYSTEMATIC ANALYSIS, Prevalence, Humans, Prospective Studies, Sex Distribution, Aged, Retrospective Studies, Science & Technology, HYPERTENSION, PERIPHERAL ARTERIAL-DISEASE, CAUSE-SPECIFIC MORTALITY, Middle Aged, Global Burden of Disease - Cardiovascular Disease, Survival Rate, 1117 Public Health And Health Services, Cardiovascular System & Hematology, Cardiovascular Diseases, DISABILITY WEIGHTS, Cardiovascular System & Cardiology, RISK-FACTORS, Female, epidemiology, Morbidity, Life Sciences & Biomedicine
Abstract

Background The burden of cardiovascular diseases (CVDs) remains unclear in many regions of the world. Objectives The GBD (Global Burden of Disease) 2015 study integrated data on disease incidence, prevalence, and mortality to produce consistent, up-to-date estimates for cardiovascular burden. Methods CVD mortality was estimated from vital registration and verbal autopsy data. CVD prevalence was estimated using modeling software and data from health surveys, prospective cohorts, health system administrative data, and registries. Years lived with disability (YLD) were estimated by multiplying prevalence by disability weights. Years of life lost (YLL) were estimated by multiplying age-specific CVD deaths by a reference life expectancy. A sociodemographic index (SDI) was created for each location based on income per capita, educational attainment, and fertility. Results In 2015, there were an estimated 422.7 million cases of CVD (95% uncertainty interval: 415.53 to 427.87 million cases) and 17.92 million CVD deaths (95% uncertainty interval: 17.59 to 18.28 million CVD deaths). Declines in the age-standardized CVD death rate occurred between 1990 and 2015 in all high-income and some middle-income countries. Ischemic heart disease was the leading cause of CVD health lost globally, as well as in each world region, followed by stroke. As SDI increased beyond 0.25, the highest CVD mortality shifted from women to men. CVD mortality decreased sharply for both sexes in countries with an SDI >0.75. Conclusions CVDs remain a major cause of health loss for all regions of the world. Sociodemographic change over the past 25 years has been associated with dramatic declines in CVD in regions with very high SDI, but only a gradual decrease or no change in most regions. Future updates of the GBD study can be used to guide policymakers who are focused on reducing the overall burden of noncommunicable disease and achieving specific global health targets for CVD.

Published
2017

18. Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: a novel analysis from the Global Burden of Disease Study 2015

Author

Barber R. M. a, Fullman N. a, Sorensen R. J. D. a, Bollyky T. f, McKee M. i, Nolte E. g, Abajobir A. A. j, Abate K. H. n, Abbafati C. o, Abbas K. M. p, Abd-Allah F. q, Abdulle A. M. r, Abdurahman, A. A. ac, Abera, S. F. ad, ah Abraham, B. ai, Abreha, G. F. ad, Adane, K. af, Adelekan, A. L. aj, ak Adetifa, I. M. O. i al, Afshin A. a, Agarwal, A. ao, ap Agarwal, S. K. aq, S. ar, Agrawal, A. as, Ahmad Kiadaliri, A. au, Ahmadi, A. ax, Ahmed, K. Y. ay, Ahmed M. B. m, Akinyemi, R. O. ak, az Akinyemiju, T. F. ba, Akseer, N. am, bc Al-Aly, Z. bd, Alam, K. be, bf dn, dq Alam, N. bg, S. S. bh, Alemu, Z. A. ay, Alene, K. A. bi, Alexander L. a, Ali, R. bm, S. D. bn, bo bp, Alizadeh-Navaei, R. bq, Alkerwi, A. bs, Alla, F. bt, Allebeck, P. bu, Allen C. a, Al-Raddadi, R. cb, Alsharif, U. cd, Altirkawi, K. A. ce, Alvarez Martin, E. cf, Alvis-Guzman, N. cg, Amare, A. T. ch, cj gr, Amini E. s, t wy, Ammar, W. cl, Amo-Adjei, J. cm, cn Amoako, Y. A. co, Anderson B. O. e, Androudi, S. cq, Ansari, H. cr, Ansha, M. G. cs, Antonio, C. A. T. ct, Ärnlöv, J. bv, cv Artaman, A. cw, Asayesh, H. cx, Assadi, R. cy, Astatkie, A. cz, Atey, T. M. ag, Atique, S. da, Atnafu, N. T. dc, dd Atre, S. R. de, Avila-Burgos, L. df, Avokpaho, E. F. G. A. dg, Ayala Quintanilla, B. P. di, dj Awasthi, A. dk, Ayele, N. N. dl, Azzopardi, P. dm, dn dr, Ba Saleem, H. O. dt, Bärnighausen, T. du, dz ea, Bacha, U. eb, Badawi, A. an, ec Banerjee, A. ed, Barac, A. eg, Barboza, M. A. ej, ek Barker-Collo, S. L. el, Barrero, L. H. en, Basu, S. eo, Baune, B. T. ch, gr Baye, K. eq, Bayou, Y. T. er, Bazargan-Hejazi, S. es, et Bedi, N. eu, Beghi, E. ev, Béjot, Y. ew, Bello, A. K. ex, Bennett, D. A. bm, Bensenor, I. M. ez, Berhane, A. fa, Bernabé, E. fd, Bernal, O. A. fe, Beyene, A. S. ff, ki Beyene, T. J. eq, fi Bhutta, Z. A. bc, fj Biadgilign, S. fk, Bikbov, B. fl, Birlik, S. M. fm, Birungi, C. ef, Biryukov S. a, Bisanzio, D. bk, Bizuayehu, H. M. fn, Bose, D. fo, Brainin, M. fp, Brauer M. a, fq Brazinova, A. fr, fs Breitborde, N. J. K. fu, Brenner, H. fw, Butt, Z. A. fx, Cárdenas, R. fy, Cahuana-Hurtado, Campos-Nonato, I. R. df, dx Car, J. fz, Carrero, J. J. bw, Casey D. a, Caso, V. ga, Castañeda-Orjuela, C. A. gb, Castillo Rivas, J. gd, ge Catalá-López, F. gf, gg Cecilio, P. gh, Cercy K. a, Charlson F. J. a, j gi, Chen A. Z. a, Chew A. a, Chibalabala, M. gj, Chibueze, C. E. gk, Chisumpa, V. H. gl, gm Chitheer, A. A. gn, Chowdhury, R. go, Christensen, H. gp, Christopher, D. J. gq, Ciobanu, L. G. ci, Cirillo, M. gs, Coggeshall M. S. a, Cooper, L. T. gt, Cortinovis, M. fl, Crump, J. A. gu, Dalal, K. gv, Danawi, H. gw, Dandona L. a, gy Dandona, R. a gy, Dargan, P. I. gz, Das Neves, J. ha, hb Davey, G. hd, Davitoiu, D. V. he, Davletov, K. hf, De Leo, D. hh, Del Gobbo, L. C. eo, Del Pozo-Cruz, B. em, Dellavalle, R. P. hi, Deribe, K. ep, hj Deribew, A. al, Des Jarlais, D. C. hk, hl Dey, S. hm, Dharmaratne, S. D. hn, Dicker D. a, Ding, E. L. dx, Dokova, K. ho, Dorsey, E. R. hp, Doyle, K. E. hq, hr Dubey, M. hs, Ehrenkranz R. a, Ellingsen, C. L. hu, Elyazar, I. hv, Enayati, A. hw, Ermakov, S. P. hx, hy Eshrati, B. hz, ia Esteghamati, A. t wz, Estep K. a, Fürst T. h, ic ie, Faghmous I. D. A. i, Fanuel, F. B. B. cz, if Faraon, E. J. A. cu, ig Farid, T. A. ih, Farinha, C. S. E. S. ii, ij Faro, A. ik, Farvid, M. S. dw, il Farzadfar, F. u xa, Feigin, V. L. im, Feigl, A. B. du, Fereshtehnejad, S. -M. bx, Fernandes, J. G. in, J. C. io, Feyissa, T. R. ip, Fischer, F. iq, Fitzmaurice C. a, b ir, Fleming T. D. a, Foigt, N. is, Foreman K. J. a, ib Forouzanfar, M. H. it, Franklin, R. C. iu, Frostad J. a, Ghiwot T. T. n, Gakidou E. a, Gambashidze, K. iv, Gamkrelidze, A. iv, Gao, W. ix, Garcia-Basteiro, A. L. iy, iz Gebre, T. ja, Gebremedhin A. T. n, jb Gebremichael, M. W. ag, Gebru, A. A. ag, jc Gelaye, A. A. jd, Geleijnse, J. M. fh, Genova-Maleras, R. je, jf Gibney, K. B. jg, Giref, A. Z. eq, Gishu, M. D. fg, jh Giussani, G. ev, Godwin W. W. a, Gold A. a, Goldberg E. M. a, Gona, P. N. ji, Goodridge, A. jj, Gopalani, S. V. jk, Goto, A. jl, Graetz N. a, Greaves, F. ib, jm Griswold, M. a Guban, P. I. jn, Gugnani, H. C. jo, Gupta, P. C. jp, R. jq, R. jr, T. js, V. jt, Habtewold, T. D. fb, jv Hafezi-Nejad, N. t xb, Haile, D. eq, Hailu, A. D. ep, jx Hailu, G. B. ag, jc Hakuzimana, A. jz, ka Hamadeh, R. R. kb, Hambisa, M. T. ff, Hamidi, S. kc, Hammami, M. kd, Hankey, G. J. ke, kf kg, Hao, Y. kh, Harb, H. L. cl, Hareri, H. A. eq, Haro, J. M. mw, Hassanvand M. S. w, xc Havmoeller, R. ca, Hay, R. J. fd, kk Hay, S. I. a bl, Hendrie, D. kl, Heredia-Pi, I. B. df, Hoek, H. W. ju, km Horino, M. ko, Horita, N. kp, Hosgood, H. D. kq, Htet, A. S. kr, ks Hu, G. kt, Huang, H. ku, J. J. kv, Huntley B. M. a, Huynh C. a, Iburg, K. M. kw, Ileanu, B. V. kx, Innos, K. ky, Irenso, A. A. fg, kj Jahanmehr, N. kz, Jakovljevic, M. B. lb, James, P. dv, S. L. lc, Javanbakht, M. ld, Jayaraman, S. P. le, Jayatilleke, A. U. lf, lg Jeemon, P. gx, lh li, nh Jha, V. bm, lk John, D. ll, Johnson C. a, Johnson S. C. a, Jonas, J. B. lm, Juel, K. ln, Kabir, Z. lo, Kalkonde, Y. lp, Kamal, R. lq, Kan, H. ls, Karch, A. lt, lu Karema, C. K. id, lv Karimi, S. M. lw, Kasaeian A. t, y xd, Kassebaum N. J. a, lx Kastor, A. hs, Katikireddi, S. V. ly, Kazanjan, Keiyoro, P. N. lz, ma Kemmer, L. a Kemp, A. H. mc, me Kengne, A. P. jz, mf Kerbo, A. A. if, Kereselidze, M. iv, Kesavachandran, C. N. lq, Khader, Y. S. mg, Khalil I. a, Khan, A. R. ih, E. A. mh, G. mi, Khang, Y. -H. mj, Khoja, A. T. A. ml, Khonelidze, I. iv, Khubchandani, J. mm, Kibret, G. D. ay, Kim, D. mn, Kim P. a, Y. J. mo, Kimokoti, R. W. mp, Kinfu, Y. mq, Kissoon, N. fq, Kivipelto, M. by, Kokubo, Y. mr, Kolk, A. ms, Kolte, D. mt, Kopec, J. A. fq, Kosen, S. mu, Koul, P. A. mv, Koyanagi, A. mw, Kravchenko, M. mx, Krishnaswami, S. my, Krohn K. J. a, Kuate Defo, B. mz, Kucuk Bicer, B. nb, Kuipers, E. J. nd, Kulkarni, V. S. ne, Kumar, G. A. lj, Kumsa, F. A. fg, kj Kutz, M. a Kyu, H. H. a Lager, A. C. J. nf, Lal, A. ng, D. K. ni, Lalloo R. k, Lallukka, T. nj, Lan, Q. nl, Langan S. M. i, Lansingh, V. C. nm, nn Larson, H. J. a h, Larsson, A. no, Laryea, D. O. cp, Latif, A. A. np, Lawrynowicz, A. E. B. nq, Leasher, J. L. nr, Leigh, J. bf, Leinsalu, M. ky, nt Leshargie, C. T. ay, Leung J. e, j Leung, R. nu, Levi, M. nv, Liang, X. nw, Lim S. S. a, Lind M. a, Linn, S. nx, Lipshultz, S. E. ny, nz Liu, P. a Liu, Y. oa, L. -T. ob, oc Logroscino, G. od, Lopez, A. D. do, Lorch, S. A. oe, Lotufo, P. A. ez, Lozano, R. df, Lunevicius, R. of, og Lyons, R. A. mb, Macarayan, E. R. K. kv, Mackay, M. T. oh, Magdy Abd El Razek, H. oi, M. oj, Mahdavi, M. ok, ol Majeed, A. ib, Malekzadeh R. z, xe Malta, D. C. on, Mantovani LG, Manyazewal, T. op, Mapoma, C. C. gl, Marcenes, W. oq, Marks, G. B. md, ns Marquez, N. a Martinez-Raga, J. or, os Marzan, M. B. ot, Massano, J. hc, ou Mathur, M. R. ni, Maulik, P. K. ov, Mazidi, M. ow, McAlinden, C. ox, oy McGrath, J. J. l McNellan, C. a Meaney, P. A. oz, pa Mehari, A. pb, Mehndiratta, M. M. pc, Meier, T. pd, Mekonnen, A. B. bf, bj Meles, K. G. ad, Memish, Z. A. pe, pf Mengesha, M. M. ff, Mengiste, D. T. ae, Mengistie M. A. n, Menota, B. G. eq, Mensah, G. A. pg, Mereta S. T. n, Meretoja, A. dp, ph Meretoja, T. J. nk, pi Mezgebe, H. B. ag, Micha, R. pj, Millear A. a, Mills, E. J. pl, Minnig S. a, Mirarefin M. a, pm Mirrakhimov, E. M. pn, po Mock, C. N. c Mohammad, K. A. pp, Mohammed, S. ea, pq Mohanty, S. K. hs, Mokdad A. H. a, Mola, G. L. D. pr, Molokhia, M. fd, Monasta, L. ps, Montico, M. ps, Moradi-Lakeh M. a, pt Moraga, P. pz, Morawska, L. pv, pw Mori, R. qa, Moses M. a, Mueller, U. O. qc, Murthy, S. fq, Musa, K. I. qd, Nachega, J. B. qe, qf qg, Nagata, C. qh, Nagel, G. qj, Naghavi M. a, Naheed, A. bh, Naldi, L. qk, Nangia, V. ql, Nascimento, B. R. qm, qn Negoi, I. qo, Neupane, S. P. ks, Newton, C. R. qp, Ng M. a, Ngalesoni, F. 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Js, Thakur, Alan, Thomson, Taavi, Tillmann, Tenaw, Yimer, Tiruye, Ruoyan, Tobe Gai, Marcello, Tonelli, Roman, Topor Madry, Miguel, Tortajada, Christopher, Troeger, Thomas, Truelsen, Abera, Kenay, Tura, Uche, Uchendu, Kingsley, N, Ukwaja, Eduardo, Undurraga, Chigozie, Jesse, Uneke, Olalekan, Uthman, Job, F, Van, Boven, Rita, Van, Dingenen, Santosh, Varughese, Tommi, Vasankari, Narayanaswamy, Venketasubramanian, Francesco, Violante, Sergey, Vladimirov, Vasiliy, Victorovich, Vlassov, Stein, Emil, Vollset, Theo, Vo, Joseph, Wagner, Tolassa, Wakayo, Stephen, Waller, Judd, Walson, Haidong, Wang, Yuan Pang, Wang, David, Watkin, Elisabete, Weiderpa, Robert, Weintraub, Chi Pang, Wen, Andrea, Werdecker, Joshua, Wesana, Ronny, Westerman, Harvey, Whiteford, James, Wilkinson, Charles, Shey, Wiysonge, Belete, Getahun, Woldeye, Charles, Wolfe, Sungho, Won, Abdulhalik, Workicho, Shimelash, Bitew, Workie, Mamo, Wubshet, Denis, Xavier, Gelin, Xu, Ajit, Kumar, Yadav, Mohsen, Yaghoubi, Bereket, Yakob, 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M., E, Ei, S, R., T, Sartorius, B., T, Ti, S, M., A, Savic, Sawhney, M., T, Saylan, M. I., T, Schöttker, Tl, S, A. E., T, Tn, S, D. C., B, Seedat, S., Q, Seid, A. M., F, Seifu, C. N., I, Sepanlou, S, Xe, S, Servan-Mori, E. E., D, Setegn, T., C, Shackelford, K, Shaheen, A., T, Shahraz, S., T, M. A., T, Shakh-Nazarova, Shamsipour, M, Xh, Shariful, I, S. M., B, Sharma, J., T, She, J., L, Sheikhbahaei, S, Wz, S, Tu, S, Shigematsu, Tw, S, M. -J., T, Shiri, Shoman, H., T, Shrime, M. G., D, Sibamo, E. L. S., I, Sigfusdottir, I. D., U, Silva, D. A. S., U, D. G. A., U, Sindi, Singh, J. A., U, O. P., U, P. K., U, V., U, Sinke, A. H., U, Sinshaw, A. E., U, Skirbekk, V., H, Kn, S, K., J, Smith, A, Sobngwi, E., U, Uk, S, S., U, Soriano, J. B., U, Sousa, T. C. M., U, Sposato, L. A., U, Sreeramareddy, C. T., U, Stathopoulou, Steel, N., J, Ur, S, Steinke, C, M. A., Q, Stranges, S., B, Strong, M., U, Stroumpoulis, K., U, Uv, S, L., I, Sufiyan, M. B., U, Suliankatchi, R. 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Subjects
Dánartíðni, Lífslíkur, Life expectancy, Diseases, Health insurance, Globan Burden of Disease, Healthcare Access, DEVELOPMENT GOALS, Methods, Psychology, LIFE EXPECTANCY, Risk assessment, Public health, Globan Burden of Disease, Injuries, Tölfræði, Sjúkdómar, Statistics, DEATH, Þjóðir, Staðtölur, 11 Medical And Health Sciences, Healthcare access, Health status indicators, Health policy, Global burden of disease, Gæðastjórnun, Sálfræði, COMPARATIVE RISK-ASSESSMENT, Lýðheilsa, Life Sciences & Biomedicine, Standards, UNITED-STATES, Sjúkratryggingar, Medicine, General & Internal, General & Internal Medicine, Heilbrigðisstefna, SYSTEMATIC ANALYSIS, Mortality, Public health systems, medicine (all), Áhættugreining, Science & Technology, Health services accessibility, Staðlar, TRENDS, Heilbrigðisþjónusta, MEDICAL-CARE, AVOIDABLE MORTALITY, Áverkar, Aðferðafræði, Quality of health care, EUROPEAN COUNTRIES, Heilbrigðiskerfi
Abstract

Background National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. Methods We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure-the Healthcare Quality and Access (HAQ) Index-on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r= 0.88), an index of 11 universal health coverage interventions (r= 0.83), and human resources for health per 1000 (r= 0.77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Findings Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28.6 to 94.6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40.7 (95% uncertainty interval, 39.0-42.8) in 1990 to 53.7 (52.2-55.4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21.2 in 1990 to 20.1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73.8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. Interpretation This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-systemcharacteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world., Bill & Melinda Gates Foundation.

Published
2017

19. Measuring the health-related Sustainable Development Goals in 188 countries: a baseline analysis from the Global Burden of Disease Study 2015

Author

Lim, Stephen S, Allen, Kate, Bhutta, Zulfiqar A, Dandona, Lalit, Forouzanfar, Mohammad H, Fullman, Nancy, Gething, Peter W, Goldberg, Ellen M, Hay, Simon I, Holmberg, Mollie, Kinfu, Yohannes, Kutz, Michael J, Larson, Heidi J, Liang, Xiaofeng, Lopez, Alan D, Lozano, Rafael, McNellan, Claire R, Mokdad, Ali H, Mooney, Meghan D, Naghavi, Mohsen, Olsen, Helen E, Pigott, David M, Salomon, Joshua A, Vos, Theo, Wang, Haidong, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abbas, Kaja M, Abd-Allah, Foad, Abdulle, Abdishakur M, Abraham, Biju, Abubakar, Ibrahim, Abu-Raddad, Laith J, Abu-Rmeileh, Niveen ME, Abyu, Gebre Yitayih, Achoki, Tom, Adebiyi, Akindele Olupelumi, Adedeji, Isaac Akinkunmi, Afanvi, Kossivi Agbelenko, Afshin, Ashkan, Agarwal, Arnav, Agrawal, Anurag, Kiadaliri, Aliasghar Ahmad, Ahmadieh, Hamid, Ahmed, Kedir Yimam, Akanda, Ali Shafqat, Akinyemi, Rufus Olusola, Akinyemiju, Tomi F, Akseer, Nadia, Al-Aly, Ziyad, Alam, Khurshid, Alam, Uzma, Alasfoor, Deena, AlBuhairan, Fadia S, Aldhahri, Saleh Fahed, Aldridge, Robert William, Alemu, Zewdie Aderaw, Ali, Raghib, Alkerwi, Ala'a, Alkhateeb, Mohammad AB, Alla, Francois, Allebeck, Peter, Allen, Christine, Al-Raddadi, Rajaa, Alsharif, Ubai, Altirkawi, Khalid A, Martin, Elena Alvarez, Alvis-Guzman, Nelson, Amare, Azmeraw T, Amberbir, Alemayehu, Amegah, Adeladza Kofi, Amini, Heresh, Ammar, Walid, Amrock, Stephen Marc, Andersen, Hjalte H, Anderson, Benjamin O, Anderson, Gregory M, Antonio, Carl Abelardo T, Anwari, Palwasha, Arnlov, Johan, Artaman, Al, Asayesh, Hamid, Asghar, Rana Jawad, Atique, Suleman, Avokpaho, Euripide Frinel G Arthur, Awasthi, Ashish, Quintanilla, Beatriz Paulina Ayala, Azzopardi, Peter, Bacha, Umar, Badawi, Alaa, Balakrishnan, Kalpana, Banerjee, Amitava, Barac, Aleksandra, Barber, Ryan, Barker-Collo, Suzanne L, Barnighausen, Till, Barrero, Lope H, Barrientos-Gutierrez, Tonatiuh, Basu, Sanjay, Bayou, Tigist Assefa, Bazargan-Hejazi, Shahrzad, Beardsley, Justin, Bedi, Neeraj, Beghi, Ettore, Bejot, Yannick, Bell, Michelle L, Bello, Aminu K, Bennett, Derrick A, Bensenor, Isabela M, Benzian, Habib, Berhane, Adugnaw, Bernabe, Eduardo, Bernal, Oscar Alberto, Betsu, Balem Demtsu, Beyene, Addisu Shunu, Bhala, Neeraj, Bhatt, Samir, Biadgilign, Sibhatu, Bienhoff, Kelly A, Bikbov, Boris, Binagwaho, Agnes, Bisanzio, Donal, Bjertness, Espen, Blore, Jed, Bourne, Rupert RA, Brainin, Michael, Brauer, Michael, Brazinova, Alexandra, Breitborde, Nicholas JK, Broday, David M, Brugha, Traolach S, Buchbinder, Rachelle, Butt, Zahid A, Cahill, Leah E, Campos-Nonato, Ismael Ricardo, Campuzano, Julio Cesar, Carabin, Helene, Cardenas, Rosario, Carrero, Juan Jesus, Carter, Austin, Casey, Daniel, Caso, Valeria, Castaneda-Orjuela, Carlos A, Castillo Rivas, Jacqueline, Catala-Lopez, Ferran, Cavalleri, Fiorella, Cecilio, Pedro, Chang, Hsing-Yi, Chang, Jung-Chen, Charlson, Fiona J, Che, Xuan, Chen, Alan Zian, Chiang, Peggy Pei-Chia, Chibalabala, Mirriam, Chisumpa, Vesper Hichilombwe, Choi, Jee-Young Jasmine, Chowdhury, Rajiv, Christensen, Hanne, Ciobanu, Liliana G, Cirillo, Massimo, Coates, Matthew M, Coggeshall, Megan, Cohen, Aaron J, Cooke, Graham S, Cooper, Cyrus, Cooper, Leslie Trumbull, Cowie, Benjamin C, Crump, John A, Damtew, Solomon Abrha, Dandona, Rakhi, Dargan, Paul I, das Neves, Jose, Davis, Adrian C, Davletov, Kairat, de Castro, E Filipa, De Leo, Diego, Degenhardt, Louisa, Del Gobbo, Liana C, Deribe, Kebede, Derrett, Sarah, Jarlais, Don C Des, Deshpande, Aniruddha, Deveber, Gabrielle A, Dey, Subhojit, Dharmaratne, Samath D, Dhillon, Preet K, Ding, Eric L, Dorsey, E Ray, Doyle, Kerrie E, Driscoll, Tim R, Duan, Leilei, Dubey, Manisha, Duncan, Bruce Bartholow, Ebrahimi, Hedyeh, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Erskine, Holly E, Eshrati, Babak, Esteghamati, Alireza, Fahimi, Saman, Farid, Talha A, Sofia e Sa Farinha, Carla, Faro, Andre, Farvid, Maryam S, Farzadfar, Farshad, Feigin, Valery L, Mendonca Felicio, Manuela, Fereshtehnejad, Seyed-Mohammad, Fernandes, Jefferson G, Fernandes, Joao C, Ferrari, Alize J, Fischer, Florian, Fitchett, Joseph RA, Fitzmaurice, Christina, Foigt, Nataliya, Foreman, Kyle, Fowkes, F Gerry R, Franca, Elisabeth Barboza, Franklin, Richard C, Fraser, Maya, Friedman, Joseph, Frostad, Joseph, Furst, Thomas, Gabbe, Belinda, Garcia-Basteiro, Alberto L, Gebre, Teshome, Gebrehiwot, Tsegaye Tewelde, Gebremedhin, Amanuel Tesfay, Gebru, Alemseged Aregay, Gessner, Bradford D, Gillum, Richard F, Ginawi, Ibrahim Abdelmageem Mohamed, Giref, Ababi Zergaw, Giroud, Maurice, Gishu, Melkamu Dedefo, Giussani, Giorgia, Godwin, William, Gona, Philimon, Goodridge, Amador, Gopalani, Sameer Vali, Gotay, Carolyn C, Goto, Atsushi, Gouda, Hebe N, Graetz, Nicholas, Greenwell, Karen Fern, Griswold, Max, Gugnani, Harish, Guo, Yuming, Gupta, Rahul, Gupta, Rajeev, Gupta, Vipin, Gutierrez, Reyna A, Gyawali, Bishal, Haagsma, Juanita A, Haakenstad, Annie, Hafezi-Nejad, Nima, Haile, Demewoz, Hailu, Gessessew Bugssa, Halasa, Yara A, Hamadeh, Randah Ribhi, Hamidi, Samer, Hammami, Mouhanad, Hankey, Graeme J, Harb, Hilda L, Haro, Josep Maria, Hassanvand, Mohammad Sadegh, Havmoeller, Rasmus, Heredia-Pi, Ileana Beatriz, Hoek, Hans W, Horino, Masako, Horita, Nobuyuki, Hosgood, H Dean, Hoy, Damian G, Htet, Aung Soe, Hu, Guoqing, Huang, Hsiang, Iburg, Kim Moesgaard, Idrisov, Bulat T, Inoue, Manami, Islami, Farhad, Jacobs, Troy A, Jacobsen, Kathryn H, Jahanmehr, Nader, Jakovljevic, Mihajlo B, James, Peter, Jansen, Henrica AFM, Javanbakht, Mehdi, Jayaraman, Sudha P, Jayatilleke, Achala Upendra, Jee, Sun Ha, Jeemon, Panniyammakal, Jha, Vivekanand, Jiang, Ying, Jibat, Tariku, Jin, Ye, Jonas, Jost B, Kabir, Zubair, Kalkonde, Yogeshwar, Kamal, Ritul, Kan, Haidong, Kandel, Amit, Karch, Andre, Karema, Corine Kakizi, Karimkhani, Chante, Karunapema, Palitha, Kasaeian, Amir, Kassebaum, Nicholas J, Kaul, Anil, Kawakami, Norito, Kayibanda, Jeanne Francoise, Keiyoro, Peter Njenga, Kemmer, Laura, Kemp, Andrew Haddon, Kengne, Andre Pascal, Keren, Andre, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khan, Abdur Rahman, Khan, Ejaz Ahmad, Khan, Gulfaraz, Khang, Young-Ho, Khoja, Tawfi K Ahmed Muthafer, Khosravi, Ardeshir, Khubchandani, Jagdish, Kieling, Christian, Kim, Cho-Il, Kim, Daniel, Kim, Sungroul, Kim, Yun Jin, Kimokoti, Ruth W, Kissoon, Niranjan, Kivipelto, Miia, Knibbs, Luke D, Kokubo, Yoshihiro, Kolte, Dhaval, Kosen, Soewarta, Kotsakis, Georgios A, Koul, Parvaiz A, Koyanagi, Ai, Kravchenko, Michael, Krueger, Hans, Defo, Barthelemy Kuate, Kuchenbecker, Ricardo S, Kuipers, Ernst J, Kulikoff, Xie Rachel, Kulkarni, Veena S, Kumar, G Anil, Kwan, Gene F, Kyu, Hmwe H, Lal, Aparna, Lal, Dharmesh Kumar, Lalloo, Ratilal, Lam, Hilton, Lan, Qing, Langan, Sinead M, Larsson, Anders, Laryea, Dennis Odai, Latif, Asma Abdul, Leasher, Janet L, Leigh, James, Leinsalu, Mall, Leung, Janni, Leung, Ricky, Levi, Miriam, Li, Yichong, Li, Yongmei, Lind, Margaret, Linn, Shai, Lipshultz, Steven E, Liu, Patrick Y, Liu, Shiwei, Liu, Yang, Lloyd, Belinda K, Lo, Loon-Tzian, Logroscino, Giancarlo, Lotufo, Paulo A, Lucas, Robyn M, Lunevicius, Raimundas, Abd El Razek, Mohammed Magdy, Magis-Rodriguez, Carlos, Mahdavi, Mahdi, Majdan, Marek, Majeed, Azeem, Malekzadeh, Reza, Malta, Deborah Carvalho, Mapoma, Chabila C, Margolis, David Joel, Martin, Randall V, Martinez-Raga, Jose, Masiye, Felix, Mason-Jones, Amanda J, Massano, Joao, Matzopoulos, Richard, Mayosi, Bongani M, McGrath, John J, Mckee, Martin, Meaney, Peter A, Mehari, Alem, Mekonnen, Alemayehu B, Melaku, Yohannes Adama, Memiah, Peter, Memish, Ziad A, Mendoza, Walter, Mensink, Gert BM, Meretoja, Atte, Meretoja, Tuomo J, Mesfin, Yonatan Moges, Mhimbira, Francis Apolinary, Micha, Renata, Miller, Ted R, Mills, Edward J, Mirarefi, Mojde, Misganaw, Awoke, Mitchell, Philip B, Mock, Charles N, Mohammadi, Alireza, Mohammed, Shafi U, Monasta, Lorenzo, De la Cruz Monis, Jonathan, Montanez Hernandez, Julio Cesar, Montico, Marcella, Moradi-Lakeh, Maziar, Morawska, Lidia, Mori, Rintaro, Mueller, Ulrich O, Murdoch, Michele E, Murimira, Brighton, Murray, Joseph, Murthy, Gudlavalleti Venkata Satyanarayana, Murthy, Srinivas, Musa, Kamarul Imran, Nachega, Jean B, Nagel, Gabriele, Naidoo, Kovin S, Naldi, Luigi, Nangia, Vinay, Neal, Bruce, Nejjari, Chakib, Newton, Charles R, Newton, John N, Ngalesoni, Frida Namnyak, Nguhiu, Peter, Nguyen, Grant, Nguyen, Quyen Le, Nisar, Muhammad Imran, Pete, Patrick Martial Nkamedjie, Nolte, Sandra, Nomura, Marika, Norheim, Ole F, Norrving, Bo, Obermeyer, Carla Makhlouf, Ogbo, Felix Akpojene, Oh, In-Hwan, Oladimeji, Olanrewaju, Olivares, Pedro R, Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Opio, John Nelson, Oren, Eyal, Ortiz, Alberto, Osborne, Richard H, Ota, Erika, Owolabi, Mayowa O, Mahesh, PA, Park, Eun-Kee, Park, Hye-Youn, Parry, Charles D, Parsaeian, Mahboubeh, Patel, Tejas, Patel, Vikram, Caicedo, Angel J Paternina, Patil, Snehal T, Patten, Scott B, Patton, George C, Paudel, Deepak, Pedro, Joao Mario, Pereira, David M, Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Phillips, Michael Robert, Piel, Frederic B, Pillay, Julian David, Pinho, Christine, Pishgar, Farhad, Polinder, Suzanne, Poulton, Richie G, Pourmalek, Farshad, Qorbani, Mostafa, Rabiee, Rynaz HS, Radfar, Amir, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Sajjad Ur, Rai, Rajesh Kumar, Rajsic, Sasa, Raju, Murugesan, Ram, Usha, Rana, Saleem M, Ranabhat, Chhabi Lal, Ranganathan, Kavitha, Rao, Puja C, Refaat, Amany H, Reitsma, Marissa B, Remuzzi, Giuseppe, Resnikoff, Serge, Ribeiro, Antonio L, Rios Blancas, Maria Jesus, Roba, Hirbo Shore, Roberts, Bayard, Rodriguez, Alina, Rojas-Rueda, David, Ronfani, Luca, Roshandel, Gholamreza, Roth, Gregory A, Rothenbacher, Dietrich, Roy, Ambuj, Roy, Nobhojit, Sackey, Ben Benasco, Sagar, Rajesh, Saleh, Muhammad Muhammad, Sanabria, Juan R, Santos, Joao Vasco, Santomauro, Damian F, Santos, Itamar S, Sarmiento-Suarez, Rodrigo, Sartorius, Benn, Satpathy, Maheswar, Savic, Miloje, Sawhney, Monika, Sawyer, Susan M, Schmidhuber, Josef, Schmidt, Maria Ines, Schneider, Ione JC, Schutte, Aletta E, Schwebel, David C, Seedat, Soraya, Sepanlou, Sadaf G, Servan-Mori, Edson E, Shackelford, Katya, Shaheen, Amira, Shaikh, Masood Ali, Levy, Teresa Shamah, Sharma, Rajesh, She, Jun, Sheikhbahaei, Sara, Shen, Jiabin, Sheth, Kevin N, Shey, Muki, Shi, Peilin, Shibuya, Kenji, Shigematsu, Mika, Shin, Min-Jeong, Shiri, Rahman, Shishani, Kawkab, Shiue, Ivy, Sigfusdottir, Inga Dora, Silpakit, Naris, Santos Silva, Diego Augusto, Silverberg, Jonathan I, Simard, Edgar P, Sindi, Shireen, Singh, Abhishek, Singh, Gitanjali M, Singh, Jasvinder A, Singh, Om Prakash, Singh, Prashant Kumar, Skirbekk, Vegard, Sligar, Amber, Soneji, Samir, Soreide, Kjetil, Sorensen, Reed JD, Soriano, Joan B, Soshnikov, Sergey, Sposato, Luciano A, Sreeramareddy, Chandrashekhar T, Stahl, Hans-Christian, Stanaway, Jeff rey D, Stathopoulou, Vasiliki, Steckling, Nadine, Steel, 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K., Breitborde, David M., Broday, Traolach S., Brugha, Rachelle, Buchbinder, Zahid A., Butt, Leah E., Cahill, Ismael Ricardo Campos, Nonato, Julio Cesar, Campuzano, Hélène, Carabin, Rosario, Cárdena, Juan Jesus, Carrero, Austin, Carter, Daniel, Casey, Valeria, Caso, Carlos A., Castañeda Orjuela, Jacqueline Castillo, Riva, Ferrán Catalá, López, Fiorella, Cavalleri, Pedro, Cecílio, Hsing Yi, Chang, Jung Chen, Chang, Fiona J., Charlson, Xuan, Che, Alan Zian, Chen, Peggy Pei Chia, Chiang, Mirriam, Chibalabala, Vesper Hichilombwe, Chisumpa, Jee Young Jasmine, Choi, Rajiv, Chowdhury, Hanne, Christensen, Liliana G., Ciobanu, Cirillo, Massimo, Matthew M., Coate, Megan, Coggeshall, Aaron J., Cohen, Graham S., Cooke, Cyrus, Cooper, Leslie Trumbull, Cooper, Benjamin C., Cowie, John A., Crump, Solomon Abrha, Damtew, Rakhi, Dandona, Paul I., Dargan, José das, Neve, Adrian C., Davi, Kairat, Davletov, E., Filipa de Castro, Diego De, Leo, Louisa, Degenhardt, Liana C., Del Gobbo, Kebede, Deribe, Sarah, Derrett, Don C., Des Jarlai, Aniruddha, Deshpande, Gabrielle A., Deveber, Subhojit, Dey, Samath D., Dharmaratne, Preet K., Dhillon, Eric L., Ding, E., Ray Dorsey, Kerrie E., Doyle, Tim R., Driscoll, Leilei, Duan, Manisha, Dubey, Bruce Bartholow, Duncan, Hedyeh, Ebrahimi, Aman Yesuf, Endrie, Sergey Petrovich, Ermakov, Holly E., Erskine, Babak, Eshrati, Alireza, Esteghamati, Saman, Fahimi, Talha A., Farid, Carla Sofi a. e., Sa Farinha, André, Faro, Maryam S., Farvid, Farshad, Farzadfar, Valery L., Feigin, Manuela Mendonca, Felicio, Seyed Mohammad, Fereshtehnejad, Jefferson G., Fernande, Joao C., Fernande, Alize J., Ferrari, Florian, Fischer, Joseph R. 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M., Jansen, Mehdi, Javanbakht, Achala Upendra, Jayatilleke, Sun Ha, Jee, Panniyammakal, Jeemon, Vivekanand, Jha, Ying, Jiang, Tariku, Jibat, Ye, Jin, Jost B., Jona, Zubair, Kabir, Yogeshwar, Kalkonde, Ritul, Kamal, Haidong, Kan, Amit, Kandel, André, Karch, Corine Kakizi, Karema, Chante, Karimkhani, Palitha, Karunapema, Amir, Kasaeian, Nicholas J., Kassebaum, Anil, Kaul, Norito, Kawakami, Jeanne Françoise, Kayibanda, Peter Njenga, Keiyoro, Laura, Kemmer, Andrew Haddon, Kemp, Andre Pascal, Kengne, Andre, Keren, Chandrasekharan Nair, Kesavachandran, Yousef Saleh, Khader, Abdur Rahman, Khan, Ejaz Ahmad, Khan, Gulfaraz, Khan, Young Ho, Khang, Tawfi k., Ahmed Muthafer Khoja, Ardeshir, Khosravi, Jagdish, Khubchandani, Christian, Kieling, Cho il, Kim, Daniel, Kim, Sungroul, Kim, Yun Jin, Kim, Ruth W., Kimokoti, Niranjan, Kissoon, Miia, Kivipelto, Luke D., Knibb, Yoshihiro, Kokubo, Dhaval, Kolte, Soewarta, Kosen, Georgios A., Kotsaki, Parvaiz A., Koul, Ai, Koyanagi, Michael, Kravchenko, Hans, Krueger, Barthelemy Kuate, Defo, Ricardo S., Kuchenbecker, Ernst J., Kuiper, Xie Rachel, Kulikoff, Veena S., Kulkarni, G., Anil Kumar, Gene F., Kwan, Hmwe H., Kyu, Aparna, Lal, Dharmesh Kumar, Lal, Ratilal, Lalloo, Hilton, Lam, Qing, Lan, Sinead M., Langan, Anders, Larsson, Dennis Odai, Laryea, Asma Abdul, Latif, Janet L., Leasher, James, Leigh, Mall, Leinsalu, Janni, Leung, Ricky, Leung, Miriam, Levi, Yichong, Li, Yongmei, Li, Margaret, Lind, Shai, Linn, Steven E., Lipshultz, Patrick Y., Liu, Shiwei, Liu, Yang, Liu, Belinda K., Lloyd, Loon Tzian, Lo, Giancarlo, Logroscino, Paulo A., Lotufo, Robyn M., Luca, Raimundas, Luneviciu, Mohammed Magdy Abd El, Razek, Carlos Magis, Rodriguez, Mahdi, Mahdavi, Marek, Majdan, Azeem, Majeed, Reza, Malekzadeh, Deborah Carvalho, Malta, Chabila C., Mapoma, David Joel, Margoli, Randall V., Martin, Jose Martinez, Raga, Felix, Masiye, Amanda J., Mason Jone, João, Massano, Richard, Matzopoulo, Bongani M., Mayosi, John J., Mcgrath, Martin, Mckee, Peter A., Meaney, Alem, Mehari, Alemayehu B., Mekonnen, Yohannes Adama, Melaku, Peter, Memiah, Ziad A., Memish, Walter, Mendoza, Gert B. 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S., Rabiee, Amir, Radfar, Vafa Rahimi, Movaghar, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Sajjad Ur, Rahman, Rajesh Kumar, Rai, Sasa, Rajsic, Murugesan, Raju, Usha, Ram, Saleem M., Rana, Chhabi Lal, Ranabhat, Kavitha, Ranganathan, Puja C., Rao, Amany H., Refaat, Marissa B., Reitsma, Giuseppe, Remuzzi, Serge, Resnikoff, Antonio L., Ribeiro, Maria Jesus Rios, Blanca, Hirbo Shore, Roba, Bayard, Robert, Alina, Rodriguez, David Rojas, Rueda, Luca, Ronfani, Gholamreza, Roshandel, Gregory A., Roth, Dietrich, Rothenbacher, Ambuj, Roy, Nobhojit, Roy, Ben Benasco, Sackey, Rajesh, Sagar, Muhammad Muhammad, Saleh, Juan R., Sanabria, Damian F., Santomauro, Itamar S., Santo, Rodrigo Sarmiento, Suarez, Benn, Sartoriu, Maheswar, Satpathy, Miloje, Savic, Monika, Sawhney, Susan M., Sawyer, Josef, Schmidhuber, Maria Inês, Schmidt, Ione J. 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Subjects
Conservation of Natural Resources, spline regressions, Health Status, Global Health, Goal, Health Statu, Cost of Illness, Risk Factors, Universal Health Insurance, Quality-Adjusted Life Year, health-related SDG performance indicators, socio-demographic index, Health Status Indicators, Humans, Conservation of Natural Resource, Disabled Persons, Health Status Indicator, Medicine(all), Insurance, Health, Risk Factor, Medicine (all), Public Health, Global Health, Social Medicine and Epidemiology, Articles, Cost of Illne, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Disabled Person, Quality-Adjusted Life Years, Universal Coverage, Goals, Human
Abstract

Summary Background In September, 2015, the UN General Assembly established the Sustainable Development Goals (SDGs). The SDGs specify 17 universal goals, 169 targets, and 230 indicators leading up to 2030. We provide an analysis of 33 health-related SDG indicators based on the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015). Methods We applied statistical methods to systematically compiled data to estimate the performance of 33 health-related SDG indicators for 188 countries from 1990 to 2015. We rescaled each indicator on a scale from 0 (worst observed value between 1990 and 2015) to 100 (best observed). Indices representing all 33 health-related SDG indicators (health-related SDG index), health-related SDG indicators included in the Millennium Development Goals (MDG index), and health-related indicators not included in the MDGs (non-MDG index) were computed as the geometric mean of the rescaled indicators by SDG target. We used spline regressions to examine the relations between the Socio-demographic Index (SDI, a summary measure based on average income per person, educational attainment, and total fertility rate) and each of the health-related SDG indicators and indices. Findings In 2015, the median health-related SDG index was 59·3 (95% uncertainty interval 56·8–61·8) and varied widely by country, ranging from 85·5 (84·2–86·5) in Iceland to 20·4 (15·4–24·9) in Central African Republic. SDI was a good predictor of the health-related SDG index (r2=0·88) and the MDG index (r2=0·92), whereas the non-MDG index had a weaker relation with SDI (r2=0·79). Between 2000 and 2015, the health-related SDG index improved by a median of 7·9 (IQR 5·0–10·4), and gains on the MDG index (a median change of 10·0 [6·7–13·1]) exceeded that of the non-MDG index (a median change of 5·5 [2·1–8·9]). Since 2000, pronounced progress occurred for indicators such as met need with modern contraception, under-5 mortality, and neonatal mortality, as well as the indicator for universal health coverage tracer interventions. Moderate improvements were found for indicators such as HIV and tuberculosis incidence, minimal changes for hepatitis B incidence took place, and childhood overweight considerably worsened. Interpretation GBD provides an independent, comparable avenue for monitoring progress towards the health-related SDGs. Our analysis not only highlights the importance of income, education, and fertility as drivers of health improvement but also emphasises that investments in these areas alone will not be sufficient. Although considerable progress on the health-related MDG indicators has been made, these gains will need to be sustained and, in many cases, accelerated to achieve the ambitious SDG targets. The minimal improvement in or worsening of health-related indicators beyond the MDGs highlight the need for additional resources to effectively address the expanded scope of the health-related SDGs. Funding Bill & Melinda Gates Foundation.

Published
2016

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